Web of Science: 7 citations, Scopus: 12 citations, Google Scholar: citations,
Rehabilitation Profiles of Older Adult Stroke Survivors Admitted to Intermediate Care Units: A Multi-Centre Study
Pérez, Laura M. (Parc Sanitari Pere Virgili (Barcelona))
Inzitari, Marco (Parc Sanitari Pere Virgili (Barcelona))
Quinn, Terence J. (University of Glasgow. Institute of Cardiovascular and Medical Sciences)
Montaner, Joan (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Gavaldà, Ricard (Universitat Politècnica de Catalunya)
Duarte, Esther (Parc de Salut Mar (Barcelona))
Coll-Planas, Laura (Universitat Autònoma de Barcelona. Fundació Salut i Envelliment)
Cerdà, Mercè (Servei Català de la Salut)
Santaeugenia, Sebastià (Badalona Serveis Assistencials)
Closa, Conxita (Corporación Fisiogestión (Barcelona))
Gallofré, Miquel (Generalitat de Catalunya. Departament de Salut)

Date: 2016
Abstract: 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 higher tertiles. Conclusion: Our data suggest that post-stroke rehabilitation profiles could be identified using routine assessment tools and showed differential recovery. If confirmed, these findings might help to develop tailored interventions to optimize recovery of older stroke patients.
Note: Número d'acord de subvenció AGAUR/SGR2014-890
Note: Número d'acord de subvenció MINECO/PCOM
Rights: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. Creative Commons
Language: Anglès
Document: article ; recerca ; publishedVersion
Subject: Malalties cerebrovasculars ; Assistència mèdica ; Pacients ; Older adult stroke survivors
Published in: PloS one, Vol. 11 Núm. 11 (November 2016) , ISSN 1932-6203

DOI: 10.1371/journal.pone.0166304
PMID: 27829011


13 p, 1.1 MB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (scientific output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles

 Record created 2017-05-22, last modified 2020-10-26



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