Yonsei Med J.  2015 Jan;56(1):262-270. 10.3349/ymj.2015.56.1.262.

Characteristics of Inpatient Care and Rehabilitation for Acute First-Ever Stroke Patients

• Chang WH
• Shin YI
• Lee SG
• Oh GJ
• Lim YS
• Kim YH

• KMID: 2352815
• DOI: http://doi.org/10.3349/ymj.2015.56.1.262

Abstract

PURPOSE
The purpose of this study was to analyze the status of inpatient care for acute first-ever stroke at three general hospitals in Korea to provide basic data and useful information on the development of comprehensive and systematic rehabilitation care for stroke patients.
MATERIALS AND METHODS
This study conducted a retrospective complete enumeration survey of all acute first-ever stroke patients admitted to three distinct general hospitals for 2 years by reviewing medical records. Both ischemic and hemorrhagic strokes were included. Survey items included demographic data, risk factors, stroke type, state of rehabilitation treatment, discharge destination, and functional status at discharge.
RESULTS
A total of 2159 patients were reviewed. The mean age was 61.5+/-14.4 years and the ratio of males to females was 1.23:1. Proportion of ischemic stroke comprised 54.9% and hemorrhagic stroke 45.1%. Early hospital mortality rate was 8.1%. Among these patients, 27.9% received rehabilitation consultation and 22.9% underwent inpatient rehabilitation treatment. The mean period from admission to rehabilitation consultation was 14.5 days. Only 12.9% of patients were transferred to a rehabilitation department and the mean period from onset to transfer was 23.4 days. Improvements in functional status were observed in the patients who had received inpatient rehabilitation treatment after acute stroke management.
CONCLUSION
Our analysis revealed that a relatively small portion of patients who suffered from an acute first-ever stroke received rehabilitation consultation and inpatient rehabilitation treatment. Thus, applying standardized clinical practice guidelines for post-acute rehabilitation care is needed to provide more effective and efficient rehabilitation services to patients with stroke.

Keyword

Stroke; inpatients; acute management; rehabilitation; Korea

MeSH Terms

Acute Disease
Aged
Aged, 80 and over
Demography
Female
Hospitalization/statistics & numerical data
Humans
*Inpatients/statistics & numerical data
Male
Middle Aged
*Patient Care/statistics & numerical data
Patient Discharge/statistics & numerical data
Recovery of Function
Risk Factors
Stroke/classification/epidemiology/*rehabilitation/therapy

Figure

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  Fig. 1 Subtypes of acute first-ever stroke. (A) Ischemic stroke. (B) Hemorrhagic stroke. ICH, intracerebral hemorrhage; SAH, subarachnoid hemorrhage; IVH, intraventricular hemorrhage; SDH, subdural hematoma.

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  Fig. 2 Demographic characteristics of acute first-ever stroke patients. (A) Age. (B) Sex. (C) Marital status. (D) Years of education.

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  Fig. 3 Initial treatment other than antiplatelet therapy for acute first-ever stroke patients. (A) Ischemic stroke. (B) Hemorrhagic stroke. IV, intravenous; tPA, tissue plasminogen activator; IA, intraarterial; UK, urokinase.

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