Predicting admission to post-acute inpatient rehabilitation in patients with acute stroke

J Rehabil Med. 2020 Sep 28;52(9):jrm00105. doi: 10.2340/16501977-2739.

Abstract

Objective: To identify predictors of admission to post-acute inpatient rehabilitation settings follow-ing acute care for stroke survivors in Taiwan.

Design: Prospective observation study.

Participants: Stroke survivors (n = 558) admitted to acute care wards for inpatient rehabilitation (62% male; mean age 60.0 ± 12.2 years).

Methods: The primary outcome was whether survivors were admitted to post-acute inpatient rehabilitation settings after discharge from acute care wards. Logistic regression model was adopted to examine the predictors of admission to post-acute inpatient rehabilitation. A receiver operating characteristic curve was drawn to compute the ability of the predictors to discriminate the outcome.

Results: Multivariate analysis results indicated Activity Measure Post-Acute Care "6-Clicks" Basic Mobility score to be the only significant predictor of admission to post-acute inpatient rehabilitation (odds ratio = 0.44, 95% confidence interval: 0.34-0.56). Receiver operating characteristic curve analysis results indicated that the cut-off point for Basic Mobility was 13 (standardized score: 33.99). This yielded a sensitivity value of 0.98 and a specificity value of 0.96 for determining the admission to post-acute inpatient rehabilitation.

Conclusion: Activity Measure Post-Acute Care "6-Clicks" Basic Mobility subscale scores at admission for acute care can predict admission to post-acute inpatient rehabilitation for stroke survivors in Taiwan. This tool can aid clinicians in formulating adequate discharge plans at an early stage, and thus improve the quality of care.

Keywords: outcome assessment; post-acute care; quality of care; rehabilitation; stroke; subacute care.

MeSH terms

  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Inpatients / statistics & numerical data*
  • Male
  • Middle Aged
  • Prospective Studies
  • Stroke / therapy*
  • Stroke Rehabilitation / methods