Stroke Outcome Measure Scores May Predict Discharge Destination
The odds of being discharged home after stroke were increased more than 12-fold in patients who had above-average outcome scores.
HealthDay News — For patients with acute or subacute stroke, outcome measure scores are associated with discharge destination, according to a review published in the Journal of Neurologic Physical Therapy.
Emily R. Thorpe, DPT, from Walsh University in North Canton, Ohio, and colleagues conducted a systematic literature review of studies in 3 databases to examine the correlation between outcome measure scores and discharge destination in adults after acute or subacute stroke.
Nine cohort studies were included in the systematic review and 5 in meta-analyses.
The researchers found that a patient was approximately 1.08 times more likely to be discharged home than to institutionalized care for every 1-point increase on the Functional Independence Measure (FIM) (odds ratio, 1.079). The likelihood of being discharged home was increased more than 12-fold for patients with stroke who performed above average (FIM ≥80; National Institutes of Health Stroke Scale (NIHSS) ≤5; odds ratio, 12.08).
Patients who performed poorly (FIM ≤39; NIHSS score ≥14) were more likely to be discharged to institutionalized care than home (odds ratio, 3.385), with admission to skilled nursing facility more likely than to inpatient rehabilitation facility. Average performance (FIM = 40 to 79; NIHSS score = 6 to 13) was associated with a 1.9-fold increased likelihood of being discharged to institutionalized care (odds ratio, 1.879).
"Outcome measure scores are strong predictors of discharge destination among patients with stroke and provide an objective means of early discharge planning," the authors write.
Thorpe ER, Garrett KB, Smith AM, et al. Outcome measure scores predict discharge destination in patients with acute and subacute stroke: a systemic review and series of meta-analyses. J Neurol Phys Ther. 2018 Jan;42(1):2-11.