Determinants of rehabilitation outcome in geriatric patients admitted to skilled nursing facilities after stroke: a Dutch multi-centre cohort study

Age Ageing. 2012 Nov;41(6):746-52. doi: 10.1093/ageing/afs105. Epub 2012 Aug 10.

Abstract

Objective: to identify important demographic, clinical and functional determinants of successful discharge of geriatric patients from skilled nursing facilities (SNFs), particularly the role of multi-morbidity.

Design: prospective cohort study with data collection at baseline and at discharge.

Setting: fifteen SNFs in the Netherlands.

Participants: of 378 eligible patients, 186 were included.

Methods: multi-disciplinary teams recorded demographic and disease characteristics, as well as functional status, cognitive functioning and multi-morbidity on admission. The study outcomes were discharge to an independent living situation within 1 year of admission and functional status at discharge (Barthel index).

Results: of the included 186 patients, 175 were followed up. Of these patients, 123 (70%) were successfully discharged. High Berg Balance Scale (BBS) and Star Cancellation test (SCT) scores independently contributed to 48% of the variance of functional status at discharge, while low age, high BBS and SCT scores were independently related to successful discharge, explaining 33% of the variance. Multi-morbidity was not an independent determinant of rehabilitation outcome.

Conclusion: geriatric patients admitted for 'low intensity' rehabilitation in SNFs after stroke appeared to have a fair prognosis for being successfully discharged. Postural control was an important determinant of both outcome measures.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition
  • Cohort Studies
  • Female
  • Geriatric Assessment / methods*
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Outcome Assessment, Health Care / methods*
  • Patient Discharge
  • Prospective Studies
  • Skilled Nursing Facilities / standards*
  • Stroke Rehabilitation*
  • Treatment Outcome