Internationale Zeitschrift für Physikalische Medizin und Rehabilitation
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Abstrakt

Association between the Ability to Turn Over on Admission and Bedridden State at Discharge for Stroke

Hideo Nishida, Sho Sasaki, Shoichiro Terashita, Tsubasa Yokote, Toshiyuki Imoto, Tomohiro Yamashita

Background: The ability to turn over is thought to reflect trunk function, and trunk function has been associated with the prognosis of stroke. Here, we evaluated the relationship between the ability to turn on admission and bedridden state at discharge in stroke patients.

Methods and findings: The study was conducted as a retrospective cohort study in a major Japanese regional hospital. Consecutive patients admitted between April 2018 to March 2019 with a diagnosis of “cerebral infarction” or “cerebral hemorrhage” were included. The definition of ‘turning over impossible’ was a listing for the need for partial or total assistance among the basic movement items recorded in the comprehensive rehabilitation implementation plan. Primary outcome was a bedridden status at discharge, defined as a score of 5 points on the modified Rankin Scale. The association between the early ability to turn over on admission and a bedridden state at discharge was analyzed by a logistic regression model with adjustment for gender, age, pre-hospitalization mRS, and presence of paralysis at admission as potential confounders. Among 1317 patients admitted, 448 patients met the study criteria. Of the 448 subjects, 254 were male, mean age was 76.1 (12.3) years and mean length of hospital stay was 27.4 (16.7) days. Odds ratio for a classification of “turning movements impossible” was 5.6 (95% confidence interval (CI) 2.3-13.9, p<0.01) and C-statistic was 0.82 (95% CI 0.77-0.87).

Conclusion: We found a statistically significant association between turning movements and a bedridden status in acute stroke patients.