Blood · 2025
Dangerous clones with complex ties to AL amyloidosis.
Редакционная статьяКомментарийНазвание и аннотация: Перевод пока не подготовлен
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Liu Wei-Ting, Lin Huey-Juan, Yeh Poh-Shiow
Аннотация
PURPOSE: To evaluate use of continuous care resources among stroke survivors and their 3-month outcomes by discharge functional status.
PATIENTS AND METHODS: This single-center retrospective cohort study included patients with transient ischemic attack or acute ischemic stroke admitted to Chi Mei Medical Center from July 2021 to June 2022. Discharge functional status was categorized by the modified Rankin Scale (mRS): Group I (0-2), Group II (3), and Group III (4-5). Data on discharge planning, medical adherence, readmissions, and 3-month outcomes were collected from medical records and telephone follow-ups. Group comparisons used Kruskal-Wallis and chi-square or Fisher's exact tests (two-sided, α<0.05).
RESULTS: Of 897 patients, 754 met inclusion criteria: Group I (50%), Group II (21%), and Group III (29%). Groups II and III were older with more severe strokes and comorbidities. Discharge destination varied: 96% of Group I returned home, versus 59% of Group II, and 33% of Group III. About one-third of Groups II and III received post-acute care (PAC), and 27% of Group III were discharged to nursing facilities. Medical adherence was high (96-97%), and 17% of Group III received home medical care. Long-Term Care (LTC) 2.0 services were utilized by 14% of Groups II and III. At 3 months, disability (mRS > 2) or death occurred in 10% of Group I, 50% of Group II, and 89% of Group III. Two-thirds of Groups II and III had medical tubes removed. Readmissions ranged from 10-17%, highest in Group III, mainly due to recurrent strokes or infections. Half of PAC participants showed functional improvements.
CONCLUSION: Stroke survivors have distinct care needs and outcomes by discharge functional status. Optimizing discharge planning and facilitating PAC and LTC 2.0 services may improve recovery, particularly for patients with significant disabilities.
PATIENTS AND METHODS: This single-center retrospective cohort study included patients with transient ischemic attack or acute ischemic stroke admitted to Chi Mei Medical Center from July 2021 to June 2022. Discharge functional status was categorized by the modified Rankin Scale (mRS): Group I (0-2), Group II (3), and Group III (4-5). Data on discharge planning, medical adherence, readmissions, and 3-month outcomes were collected from medical records and telephone follow-ups. Group comparisons used Kruskal-Wallis and chi-square or Fisher's exact tests (two-sided, α<0.05).
RESULTS: Of 897 patients, 754 met inclusion criteria: Group I (50%), Group II (21%), and Group III (29%). Groups II and III were older with more severe strokes and comorbidities. Discharge destination varied: 96% of Group I returned home, versus 59% of Group II, and 33% of Group III. About one-third of Groups II and III received post-acute care (PAC), and 27% of Group III were discharged to nursing facilities. Medical adherence was high (96-97%), and 17% of Group III received home medical care. Long-Term Care (LTC) 2.0 services were utilized by 14% of Groups II and III. At 3 months, disability (mRS > 2) or death occurred in 10% of Group I, 50% of Group II, and 89% of Group III. Two-thirds of Groups II and III had medical tubes removed. Readmissions ranged from 10-17%, highest in Group III, mainly due to recurrent strokes or infections. Half of PAC participants showed functional improvements.
CONCLUSION: Stroke survivors have distinct care needs and outcomes by discharge functional status. Optimizing discharge planning and facilitating PAC and LTC 2.0 services may improve recovery, particularly for patients with significant disabilities.