J Korean Acad Rehabil Med.  2009 Dec;33(6):675-681.

Effects of Critical Pathway on the Start of Rehabilitation in Stroke Patients of Single University Hospital

• Lim JY
• Kang EK
• Oh MK
• Han MK
• Kwon OK
• Oh CW
• Bae HJ
• Paik NJ

Abstract

OBJECTIVE
To evaluate the effects of rehabilitation-start critical pathway (Rehab-CP) based on modified Rankin scale (mRS) on stroke outcomes. METHOD: We compared stroke outcome between before and after the carrying into effect of Rehab-CP by retrospective medical record review. First-onset stroke patients admitted to neurology department, and transferred to rehabilitation department were included in the analysis. Hospital length of stay (LOS), home discharge rate, functional outcome such as mRS, Brunnstrom stage, Korean version of modified Barthel index, Fugl-Meyer scale, mini-mental status examination, Berg Balance scale at discharge and 3 months after onset were analyzed.
RESULTS
Thirty-nine patients before the commencement of Rehab-CP and 46 patients after the Rehab-CP were compared. Length of stay in neurology department were 2.5 days shorter in after Rehab-CP group as compared to before Rehab-CP group (p=0.056) and total LOS were 1.9 days shorter in after Rehab-CP group (p=0.485), although this did not reach statistical significant difference. There were no differences in home discharge rate, and other functional outcomes between two groups (p>0.05).
CONCLUSION
Rehabilitation-start CP based on mRS may decrease LOS without affecting functional outcome, and this result primarily comes from the shortening of stay in neurology department before transfer to rehabilitation ward.

Keyword

Stroke; Critical pathway; Rehabilitation; Transfer

MeSH Terms

Critical Pathways
Humans
Length of Stay
Lifting
Medical Records
Neurology
Retrospective Studies
Stroke