影響腦中風患者復健治療住院天數長短的因素

Factors Influencing Length of Stay in Rehabilitation Ward for Stroke Patients

林昭宏(Jau-Hong Lin) ； 黃茂雄(Mao-Hsiung Huang) ； 劉景寬(Ching-Kuan Liu) ； 林永哲(Young-Tso Lin)

《物理治療》 25卷2期 (2000/03) Pp. 64-74

摘要

研究背景與目的：本研究目的是探討影響腦中風患者接受復健治療住院天數長短的因素。方法：本研究以高雄醫學大學附設中和醫院民國入十六年一月至十二月期間因腦中風住院在復健病房接受復健治療之163位患者為對象。在剛住院復健科時，使用功能獨立自主量表(Functional Independence Measure, FIM)來評估日常生活功能和加拿大神經量表(Canadian Neurological scale, CNS)來評估中風息者神經系統損傷的情況。收集患者社會人口學及臨床診斷資料和剛住院時FIM和CNS得分結果做為預測復健治療住院天數長短的變項。結果：163位患者接受復健治療平均住院天數34.4±17.2天。復迴歸分析結果發現：住院時FIM量表得分能力、是否肩關節有半脫位、是否兩側肢體運動功能皆受損和接受教育年數是為影響復健治療住院天數長短的的重要預測因素。相關重要因素可以解釋復徒治療往院天數長短26.1%的變異量。結論：這些結果可以做為未來腦中風志者接受住院復健治療健保給付規劃論病例計酬標準的參考。

關鍵字

腦中風 ； 復健治療 ； 住院天數 ； 功能獨立自主量表 ； 加拿大神經量表

並列摘要

Background and purpose: To investigate predictive variables of length of stay (LOS) for stroke rehabilitation. Methods: We prospectively studied 163 stroke patients consecutively admitted to the inpatient rehabilitation department of Kaohsiung Medical University Hospital from January 1 to December 31, 1997. At admission, functional ability of each subject was evaluated with the Functional Independence Measure (FIM(superscript TM)) instrument. Neurologic impairment as stroke severity was measured using the Canadian Neurological Scale (CNS). In addition, major medical and demographic variables were also examined as independent variables. Results: The mean LOS was 34.4±17.2 days. Multiple regression analysis indicated that admission FIM score, shoulder subluxation, bilateral limbs involvement and the level of education significantly predicted LOS. But, the variance of the LOS was explained only 26.1%. Conclusions: The results of this study suggest that these objective predictors can be used as the basis of reimbursement for stroke rehabilitation in case payment system in the future.

並列關鍵字

Stroke ； Rehabilitation therapy ； Length of stay ； Functional independedce measure ； Canadian Neurological scale