Physical Therapy Korea
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Phys. Ther. Korea 2024; 31(1): 48-54
Published online April 20, 2024
https://doi.org/10.12674/ptk.2024.31.1.48
© Korean Research Society of Physical Therapy
Factors Influencing Discharge Destination and Length of Stay in Stroke Patients in Restorative Rehabilitation Institution
Gyu-Bum Lee1 
, MD, Jee-Sun Lee1 , MD, Jeong Soo Kim2,3 , PhD
1Department of Rehabilitation Medicine, 2Department of Physical Therapy, Seoul Rehabilitation Hospital, Seoul, 3Department of Physical Therapy, College of Health Sciences, Yonsei University, Wonju, Korea
Correspondence to: Jeong Soo Kim
E-mail: suah7475@hanmail.net
https://orcid.org/0000-0001-9994-9360
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Promoting patients’ safe return home at discharge and reducing length of stay in hospital is key for Restorative Rehabilitation Institution (RMI).
Objects: This study was designed to identify the factors influencing the return to home and length of stay among various factors.
Methods: A total of 120 stroke patients (76 males and 44 females) who were hospitalized in an adult inpatient unit of a RMI for more than 2 months were retrospectively analyzed for this study (multivariate logistic regression analyses, p < 0.001). As predictor variables for assessing the return to home and length of stay, demographic data (sex, age, duration between onset and admission, length of stay, caregiver after discharge, occupation after discharge, reason for discharge, and household type after discharge) were collected. Additionally, following measurements were selectively collected from patient’s medical records: scores of Mini-Mental State Examination Korean version (K-MMSE), modified Barthel Index Korean version (K-MBI), Berg Balance Scale and Functional Ambulation Category were obtained at admission and discharge.
Results: The K-MMSE at admission and K-MBI at discharge were found to be the predictors of return to home. Additionally, K-MBI at admission influenced the length of stay.
Conclusion: This study suggests cognitive functioning at admission and the level of activities of daily living at discharge predicted the return to home and length of stay.
Keywords: Activities of daily living, Cognition, Prognosis, Rehabilitation, Stroke
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Original Article
Phys. Ther. Korea 2024; 31(1): 48-54
Published online April 20, 2024 https://doi.org/10.12674/ptk.2024.31.1.48
Copyright © Korean Research Society of Physical Therapy.
Factors Influencing Discharge Destination and Length of Stay in Stroke Patients in Restorative Rehabilitation Institution
Gyu-Bum Lee1 , MD, Jee-Sun Lee1 , MD, Jeong Soo Kim2,3 , PhD
1Department of Rehabilitation Medicine, 2Department of Physical Therapy, Seoul Rehabilitation Hospital, Seoul, 3Department of Physical Therapy, College of Health Sciences, Yonsei University, Wonju, Korea
Correspondence to:Jeong Soo Kim
E-mail: suah7475@hanmail.net
https://orcid.org/0000-0001-9994-9360
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Promoting patients’ safe return home at discharge and reducing length of stay in hospital is key for Restorative Rehabilitation Institution (RMI).
Objects: This study was designed to identify the factors influencing the return to home and length of stay among various factors.
Methods: A total of 120 stroke patients (76 males and 44 females) who were hospitalized in an adult inpatient unit of a RMI for more than 2 months were retrospectively analyzed for this study (multivariate logistic regression analyses, p < 0.001). As predictor variables for assessing the return to home and length of stay, demographic data (sex, age, duration between onset and admission, length of stay, caregiver after discharge, occupation after discharge, reason for discharge, and household type after discharge) were collected. Additionally, following measurements were selectively collected from patient’s medical records: scores of Mini-Mental State Examination Korean version (K-MMSE), modified Barthel Index Korean version (K-MBI), Berg Balance Scale and Functional Ambulation Category were obtained at admission and discharge.
Results: The K-MMSE at admission and K-MBI at discharge were found to be the predictors of return to home. Additionally, K-MBI at admission influenced the length of stay.
Conclusion: This study suggests cognitive functioning at admission and the level of activities of daily living at discharge predicted the return to home and length of stay.
Keywords: Activities of daily living, Cognition, Prognosis, Rehabilitation, Stroke
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Table 1 . Participant characteristics between the HR and OHT groups (N = 120).
Variable HR (n = 77) OHT (n = 43) p-value Sexa 0.626 Male 50 26 Female 27 17 Age (y)b 61.53 ± 13.29 64.48 ± 12.05 0.230 DOA (d)b 43.92 ± 24.72 47.90 ± 21.07 0.353 Period of admission (d)b 132.81 ± 47.20 145.51 ± 48.14 0.167 Reason for dischargea 0.001 Improvement 72 30 Others 5 13 Caregivera 0.548 Yes 75 41 No 2 2 Values are presented as number or mean ± standard deviation. HR, home return; OHT, other hospital transfer; DOA, duration between onset and admission. aChi-square test, bt-test..
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Table 2 . Differences in clinical measures between the HR and the OHT group at admission (N = 120).
Variable HR (n = 83) OHT (n = 47) p-value K-MMSE 24.26 ± 6.20 18.09 ± 9.75 < 0.001 K-MBI 62.17 ± 22.41 40.56 ± 25.86 < 0.001 BBS 35.60 ± 17.01 22.35 ± 19.14 < 0.001 FAC 0 9 17 < 0.001 1 9 10 2 18 5 3 18 5 4 17 2 5 6 4 Values are presented as number or mean ± standard deviation. HR, home return; OHT, other hospital transfer; K-MMSE, Mini-Mental State Examination Korean version; K-MBI, Modified Barthel Index Korean version; BBS, Berg Balance Scale; FAC, Functional Ambulation Category..
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Table 3 . Differences in clinical measures between HR and OHT group at discharge (N = 120).
Variable HR (n = 83) OHT (n = 47) p-value K-MMSE 27.47 ± 3.85 22.05 ± 8.42 < 0.001 K-MBI 87.27 ± 11.92 62.65 ± 29.17 < 0.001 BBS 48.35 ± 11.16 35.77 ± 18.01 < 0.001 FAC 0 0 2 < 0.001 1 1 8 2 4 7 3 9 7 4 22 10 5 41 9 Values are presented as number or mean ± standard deviation. HR, home return; OHT, other hospital transfer; K-MMSE, Mini-Mental State Examination Korean version; K-MBI, Modified Barthel Index Korean version; BBS, Berg Balance Scale; FAC, Functional Ambulation Category..
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Table 4 . Logistic regression analysis of factors related HR (N = 120).
B 95% CI Odds ratio p-value K-MMSE-admission 0.073 1.014–1.141 1.076 0.016 K-MBI-discharge 0.060 1.032–1.092 1.062 < 0.001 HR, home return; CI, confidence interval; K-MMSE, Mini-Mental State Examination Korean version; K-MBI, Modified Barthel Index Korean version..
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Table 5 . Prediction of HR: sensitivity, specificity, Youden’s index, and likelihood ratio.
Optimal cuff off score Sensitivity Specificity Youden’s index (J) K-MMSE-admission 22.50 0.727 0.605 0.332 K-MBI-discharge 74.50 0.857 0.628 0.485 HR, home return; K-MMSE, Mini-Mental State Examination Korean version; K-MBI, Modified Barthel Index Korean version..
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Table 6 . Regression analysis of factors related to the period of hospitalization (N = 120).
B t p-value VIF Constant 164.692 9.868 < 0.001 NA K-MBI-admission –0.502 –3.062 0.003 1.000 VIF, variance inflation factor; NA, not available; K-MBI, Modified Barthel Index Korean version..