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KMID : 1140920210450030215
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Annals of Rehabilitation Medicine
2021 Volume.45 No. 3 p.215 ~ p.223
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Outcome Prediction for Patients With Ischemic Stroke in Acute Care: New Three-Level Model by Eating and Bladder Functions
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Uchida Kensaku
Uchiyama Yuki
Domen Kazuhisa
Koyama Tetsuo
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Abstract
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Objective: To develop a new prediction model by combining independence in eating and bladder management functions, and to assess its utility in an acute care setting.
Methods: Patients with ischemic stroke who were admitted in our acute stroke care unit (n=250) were enrolled in this study. Functional Independence Measure (FIM) scores for eating and bladder management on the initial day of rehabilitative treatment (median, 3 days) were collected as predictive variables. These scores were divided into low (<5) and high (≥5) and categorized as values 0 and 1, respectively. From the simple summation of these two-level model values, we derived a three-level model that categorized the scores as values 0, 1, and 2. The FIM-motor scores at discharge (median, 14 days) were collected as outcome measurements. The three-level model was assessed by observing the distribution patterns of the outcome FIM-motor scores and logistic regression analyses.
Results: The median outcome FIM-motor score was 19 (interquartile range [IQR],13.8?45.3) for the value 0 category (n=14), 66.5 (IQR, 59.5?81.8) for the value 1 category (n=16), and 84 (IQR, 77?89) for the value 2 category (n=95) in the three-level model. Data fitting by logistic regression for FIM-motor scores of 41.3 and 61.4 reached 50% probability of values 1 and 2, respectively.
Conclusion: Despite the simplicity of the three-level model, it may be useful for predicting outcomes of patients with ischemic stroke in acute care.
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KEYWORD
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Disability, Measurement, Prognosis, Recovery
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