Length of Stay in In-Patient Rehabilitation after Stroke in Qatar

Loganathan Venkatachalm,Rajvir Singh,Hilda Uribazo Garrido,Ana Bobinac Georgievski,Wafaa Al Yazeedi

doi:10.1100/tsw.2008.81

Abstract

The objective of this study was to analyze the factors predicting length of stay in a stroke patient rehabilitation unit at Hamad Medical Corporation (HMC) in Qatar. The medical rehabilitation data of 100 stroke patients discharged from a 15-bed inpatient rehabilitation unit (IPRU) were collected retrospectively from medical records during the period from September 2004 to April 2007. A questionnaire was developed, and variables included in the study were age of the patient, length of stay in acute care (LOSa), length of stay in rehabilitation (LOSr), functional independence measure on admission and discharge (FIMa and FIMd), modified disability scale, and modified mobility scale. Patients were grouped by impairments defined by cause as ischemic or hemorrhagic stroke, and right or left body side deficit. A significant negative correlation was observed between LOSr and FIMa (r = −0.44, p = 0.00), and positive correlation between LOSr and LOSa (r = 0.37, p = 0.00). There was no correlation between LOSr and FIMd (r = −0.03, p= 0.76). We observed that low admission FIMa and FIMd were related to extended LOS in both acute and IPRU. Multivariate regression analysis was performed by taking age, LOSa, cause of hemorrhage or ischemia, and FIMa as independent variables, and LOSr as dependent variable. The model could explain only 26% variation for LOSr. This study supports the hypothesis of an association between LOSr, LOSa, and FIMa. Further research is needed to confirm the results of this and other similar studies.

Highlights

Cerebrovascular accident is one of the major illnesses causing disability in human beings
The majority of stroke patients on discharge were in the disability range of independence in self-care (46%), followed by moderate assistance for daily living (26%)
Many clinical studies on predictors of functional outcome after stroke have been published in the world literature, but this present study is a pioneering study of functional outcome after stroke, in Qatar

Summary

Introduction

Cerebrovascular accident (stroke) is one of the major illnesses causing disability in human beings. With an incidence of 600,000 new cases per year in the U.S, stroke stands out as the third leading cause of death, the leading cause of paralysis, and a major cause of disability[1]. Stroke is a major health problem in Qatar. The average annual incidence of stroke for 5 years was 11.7/100,000 population[2,3]. Prediction of length of stay (LOS) has become increasingly important for policy makers in health care administration. Fourteen studies found age negatively correlated with function on or after discharge, and four studies showed no correlation[4]. Brosseau et al.[5] reported that the prediction of poststroke rehabilitation LOS involved the process of functional recovery in stroke patients.

Objectives

Methods

Results

Conclusion