Abstract
Background:
Discharge planning is crucial for post-stroke patients. We evaluated clinical parameters related with discharging patients to nursing homes, using data from 39 major hospitals from the Taiwan Stroke Registry.
Methods
We randomly assigned 21,575 stroke patients recorded in 3-to-1 derivation and validation groups from 2006 to 2008. We used the derivation group to create a predictive model by evaluating cumulative risk scores linked with potential predictors: age, sex, hypertension, diabetes mellitus, heart disease, stroke history, snoring, major carers, stroke kinds, and national health institutes (NIHSS).
Probability of home care nursing and odds ratio (OR) of home care nursing relative to home care by cumulative risk scores were measured for prediction. The area under the recipient operating characteristic curve (AUROC) was used to evaluate model discrimination versus validation group.
Results
All remaining possible indicators, except for hypertension, were significant independent predictors linked with stroke-patient disposition to home care following hospital release. Age and NIHSS increased risk substantially. Patients with 15 or greater cumulative risk score had 86.4 OR for nursing home disposition.
The AUROC plots exhibited similar curved regions for the derivation group (.86, 95% confidence interval [CI],.85-.87) and validation group (.84, 95 percent CI, .83-.86).
Conclusions
Cumulative risk score is an easy-to-estimate method to prepare stroke patients and their families for discharge disposal.
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