Prognostication accuracy of final destination in poststroke patients requiring transitional care.

Abstract

Transitional care program in Australia targets older patients in hospitals requiring ongoing slow-stream restorative care prior to discharge. Poststroke patients often require extended care and are transferred to these facilities. Transitional care providers require a predicted discharge destination. The aim of this study was to assess the accuracy of this prediction. This study included all patients transferred to transitional care from a stroke rehabilitation unit over eight years. Information regarding the predicted final discharge destination was collected from medical records, and the actual discharge destination was obtained from the transitional care registry. Final destination prediction was equivalent between medical and multidisciplinary teams (κ=0.87). However, only 60% of the predictions were accurate. Subgroup analysis, as measured by the Modified Barthel Index, suggested that functional gain was a better predictor of final destination. Other characteristics, such as age, sex and type of stroke, did not demonstrate good correlation with the final destination. Functional improvement, that is the Modified Barthel Index, is the best predictor of final destination after transitional care.