Abstract WP140: Functional Independence Scores of Acute Stroke Patients is Associated With Discharge Directly to Home

Abstract

Background and purpose: Functional Independence Measure (FIM) is a valid tool to estimate the level of ADL. However, there were few studies whether FIM score in acute stroke patients is associated with the short-term outcome. Our aim is to reveal whether FIM scores within 3 days from admission to a stroke unit can predict the short-term good outcome (discharge directly to home). Method: We used data from a prospectively collected observational registry in a single stroke center between January 2016 and March 2017. Baseline NIHSS score, acute FIM score (= within 3 days from admission to the stroke unit), discharge FIM score (= at discharge from the stroke unit) were collected. FIM efficiency was calculated from (discharge FIM - acute FIM)/ the length of hospital stay. Logistic regression analysis was used to determine the independent predictors of discharge directly to home. Results: Of 678 patients were admitted to our stroke center due to acute stroke, 410 patients whose clinical data could be obtained (60%; mean age, 74±13 years; male, 57%; the median of length of hospital stay, 21 days; 75% with ischemic stroke) were enrolled. The median of the baseline NIHSS score, acute FIM score, and FIM efficiency were 5 (interquartile range [IQR], 2-16), 53 (IQR 22-83), and 0.88 (IQR 0.10-1.73), respectively. In univariate logistic regression analysis, male sex, acute ischemic stroke, baseline NIHSS score, acute FIM score, discharge FIM score, the length of hospital stay, and FIM efficiency were associated with discharge directly to home. In multivariate logistic regression analysis, acute FIM score (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.03-1.06; p<0.01) and FIM efficiency (OR 1.63; 95% CI 1.32-2.08; p<0.01) were independent predictors of discharge directly to home. Discharge FIM score was excluded from the multivariate model because discharge FIM strongly correlated with FIM efficiency (ρ=0.71; p<0.01). The optimal cut-off point of acute FIM score to predict discharge to home was >71, with a sensitivity of 72%, specificity of 88%, and an area under the curve of 0.86 (p<0.01). Conclusions: FIM scores within 3 days from admission to a stroke unit can predict discharge directly to home, which can help stroke physicians to expect the short-term outcomes.