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Rehabilitation profiles of older adult stroke survivors admitted to intermediate care units: A multi-centre study

التفاصيل البيبلوغرافية
العنوان: Rehabilitation profiles of older adult stroke survivors admitted to intermediate care units: A multi-centre study
المؤلفون: Pérez, Laura M., Inzitari, Marco, Quinn, Terence J., Montaner, Joan, Gavaldà Mestre, Ricard, Duarte, Esther, Coll Planas, Laura, Cerdá, Mercé, Santaeugenia, Sebastia, Closa, Conxita, Gallofre, Miquel
المساهمون: Universitat Politècnica de Catalunya. Departament de Ciències de la Computació, Universitat Politècnica de Catalunya. LARCA - Laboratori d'Algorísmia Relacional, Complexitat i Aprenentatge
سنة النشر: 2016
المجموعة: Universitat Politècnica de Catalunya, BarcelonaTech: UPCommons - Global access to UPC knowledge
مصطلحات موضوعية: Àrees temàtiques de la UPC::Informàtica::Aplicacions de la informàtica, Àrees temàtiques de la UPC::Ciències de la salut::Medicina, Cerebrovascular disease -- Patients -- Rehabilitation, Cluster-analysis, Inpatient rehabilitation, Discharge destination, Functional outcomes, Malalties cerebrovasculars -- Pacients -- Rehabilitació
الوصف: Background: Stroke is a major cause of disability in older adults, but the evidence around post-acute treatment is limited and heterogeneous. We aimed to identify profiles of older adult stroke survivors admitted to intermediate care geriatric rehabilitation units. Methods: We performed a cohort study, enrolling stroke survivors aged 65 years or older, admitted to 9 intermediate care units in Catalonia-Spain. To identify potential profiles, we included age, caregiver presence, comorbidity, pre-stroke and post-stroke disability, cognitive impairment and stroke severity in a cluster analysis. We also proposed a practical decision tree for patient’s classification in clinical practice. We analyzed differences between profiles in functional improvement (Barthel index), relative functional gain (Montebello index), length of hospital stay (LOS), rehabilitation efficiency (functional improvement by LOS), and new institutionalization using multivariable regression models (for continuous and dichotomous outcomes). Results: Among 384 patients (79.1±7.9 years, 50.8% women), we identified 3 complexity profiles: a) Lower Complexity with Caregiver (LCC), b) Moderate Complexity without Caregiver (MCN), and c) Higher Complexity with Caregiver (HCC). The decision tree showed high agreement with cluster analysis (96.6%). Using either linear (continuous outcomes) or logistic regression, both LCC and MCN, compared to HCC, showed statistically significant higher chances of functional improvement (OR = 4.68, 95%CI = 2.54–8.63 and OR = 3.0, 95%CI = 1.52–5.87, respectively, for Barthel index improvement =20), relative functional gain (OR = 4.41, 95%CI = 1.81–10.75 and OR = 3.45, 95%CI = 1.31–9.04, respectively, for top Vs lower tertiles), and rehabilitation efficiency (OR = 7.88, 95%CI = 3.65–17.03 and OR = 3.87, 95%CI = 1.69–8.89, respectively, for top Vs lower tertiles). In relation to LOS, MCN cluster had lower chance of shorter LOS than LCC (OR = 0.41, 95%CI = 0.23–0.75) and HCC (OR = 0.37, 95%CI = 0.19–0.73), for LOS lower Vs ...
نوع الوثيقة: article in journal/newspaper
وصف الملف: 13 p.; application/pdf
اللغة: English
تدمد: 1932-6203
العلاقة: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0166304Test; Pérez, L., Inzitari, M., Quinn, T., Montaner, J., Gavaldà, R., Duarte, E., Coll, L., Cerdá, M., Santaeugenia, S., Closa, C., Gallofre, M. Rehabilitation profiles of older adult stroke survivors admitted to intermediate care units: A multi-centre study. "PLoS one", 9 Novembre 2016, vol. 11, núm. 11, p. 1-13.; http://hdl.handle.net/2117/98769Test
DOI: 10.1371/journal.pone.0166304
الإتاحة: https://doi.org/10.1371/journal.pone.0166304Test
http://hdl.handle.net/2117/98769Test
حقوق: http://creativecommons.org/licenses/by/3.0/esTest/ ; Open Access
رقم الانضمام: edsbas.C766E59C
قاعدة البيانات: BASE
الوصف
تدمد:19326203
DOI:10.1371/journal.pone.0166304