Imagine you’re a detective trying to solve a complex case. You gather clues from different sources and piece them together to uncover the truth. Similarly, researchers in central Taiwan set out to unravel the mysteries of stroke recovery by combining various assessment parameters. In this study, they retrospectively analyzed data from stroke patients in a post-acute care program to determine which assessment factors could predict clinical outcomes. They looked at functional ability, oral intake, nutritional status, balance, motor skills, mental state, language capabilities, and quality of life. The results were fascinating! The researchers found that improvements in physical and cognitive functions were associated with lower readmission rates and reduced mortality after post-acute care. They also discovered that certain parameters could affect the length of stay during post-acute care. Using logistic regression analysis, they identified that significant improvements in multiple functions and higher scores on specific assessments were linked to better patient outcomes. This comprehensive approach to assessment provides valuable information for designing effective rehabilitation therapies for stroke patients in post-acute care. It’s like cracking the code to unlock the power of multi-parameter assessments for stroke recovery! If you’re curious to learn more about their findings, check out the full article.

Background and ObjectiveIn 2014, Taiwan’s National Health Insurance administration launched a post-acute care (PAC) program for patients to improve their functions after acute stroke. The present study was aimed to determine PAC assessment parameters, either alone or in combination, for predicting clinical outcomes.MethodsWe retrospectively enrolled stroke adult patients through one PAC network in central Taiwan between January 2014 and December 2020. We collected data on post-stroke patients’ functional ability at baseline and after PAC stay. The comprehensive assessment included the following: Modified Rankin Scale (MRS), Functional Oral Intake Scale (FOIS), Mini-Nutritional Assessment (MNA), Berg Balance Scale (BBS), Fugl-Meyer Assessment (FMA), Mini-Mental State Examination (MMSE), aphasia test, and quality of life. The above items were assessed first at baseline and again at discharge from PAC. Logistic regression was used to determine factors that were associated with PAC length of stay (LOS), 14-day hospital readmission, and 1-year mortality.ResultsA total of 267 adults (mean age 67.2 ± 14.7 years) with completed data were analyzed. MRS, activities of daily living (ADLs), instrumental activities of daily living (IADLs), BBS, and MMSE all had improved between disease onset and PAC discharge. Higher baseline and greater improvement of physical and cognitive functions between initial and final PAC assessments were significantly associated with less readmission, and lower mortality. Furthermore, the improved ADLs, FOIS, MNA, FMA-motor, and MMSE scores were related to LOS during PAC. Using logistic regression, we found that functional improvements ≥5 items [adjusted odds ratio (aOR) = 0.16; 95% confidence interval (CI) = 0.05–0.45] and improved MMSE (aOR = 0.19; 95% CI = 0.05–0.68) were significantly associated with reduced post-PAC mortality or readmission. Whereas, functional improvements ≥7 items, improved FOIS, and MNA significantly prolonged LOS during PAC.ConclusionPhysical performance parameters of patients with acute stroke improved after PAC. PAC assessment with multiple parameters better predicted clinical outcomes. These parameters could provide information on rehabilitation therapy for acute stroke patients receiving PAC.

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