The interaction of aspiration pneumonia with demographic and cerebrovascular disease risk factors is predictive of discharge level of care in acute stroke patient
| Autor: | Nneka L. Ifejika-Jones, Elizabeth A. Noser, Gerard E. Francisco, Nusrat Harun, James C. Grotta, Hui Peng |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty MEDLINE Physical Therapy Sports Therapy and Rehabilitation Aspiration pneumonia Logistic regression Pneumonia Aspiration Rehabilitation Centers Risk Assessment Severity of Illness Index Enteral Nutrition Risk Factors Severity of illness medicine Humans Stroke Aged Retrospective Studies Skilled Nursing Facilities business.industry Rehabilitation Age Factors Retrospective cohort study medicine.disease Patient Discharge Hospitalization Pneumonia Hypertension Multivariate Analysis Physical therapy Female Risk assessment business Subacute Care |
| Zdroj: | American journal of physical medicinerehabilitation. 91(2) |
| ISSN: | 1537-7385 |
| Popis: | OBJECTIVE This study aimed to evaluate factors that help determine the post-acute level of care for stroke patients with aspiration pneumonia (ASPNA). DESIGN This was a retrospective observational study of patients admitted to the University of Texas at Houston Medical School Stroke Service between July 2004 and October 2009 with discharge dispositions of home, inpatient rehabilitation, skilled nursing facility, or subacute care (n = 3511). Demographics, stroke risk factors, and National Institutes of Health Stroke Scale (NIHSS) values were collected. Interactions were evaluated between ASPNA and aging, ASPNA and NIHSS, ASPNA and use of tube feeding, and ASPNA and history of stroke. Using multivariable logistic regression, the data were analyzed for differences in disposition among patients with ASPNA. RESULTS There were significant correlations between ASPNA and an NIHSSvalue of 7.44 or greater for discharge to inpatient rehabilitation, skilled nursing facility, or subacute care compared with discharge to home (P = 0.0138); between ASPNA and an NIHSS value of 10.93 or greater for discharge to skilled nursing facility or subacute care compared with inpatient rehabilitation (P < 0.0001); and between ASPNA and age greater than 69.30 yrs for discharge to subacute care compared with a skilled nursing facility (P G 0.0001). CONCLUSIONS Patients with ASPNA and an NIHSS value of 7.44 or greater are more likely to require additional postacute care. ASPNA and an NIHSS value of 10.93 or greater increased the chance of postacute care at a level suggestive of lower functional status (skilled nursing facility or subacute care compared with inpatient rehabilitation). Age greater than 69.30 yrs plus ASPNA increased the likelihood of placement in subacute care vs. a skilled nursing facility. |
| Databáze: | OpenAIRE |
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