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Premorbid instrumental activities of daily living predicts discharge home following stroke

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Background and purpose Stroke survivors who remain dependent require multiple healthcare resources, including rehabilitation and nursing care. The effect of premorbid instrumental ADL (IADL) on the discharge destination, which has… Click to show full abstract

Background and purpose Stroke survivors who remain dependent require multiple healthcare resources, including rehabilitation and nursing care. The effect of premorbid instrumental ADL (IADL) on the discharge destination, which has not been studied previously in detail, is analyzed. Materials and methods Between April and September 2015, 40 stroke patients admitted to hospital were enrolled prospectively in the present study. The ADL (Barthel index) and IADL (Frenchay activities index: FAI) scores in their premorbid status were recorded. Baseline demographic data, stroke severity (NIHSS) and type of stroke, and whether they lived with family were also recorded. Simple univariate regression was performed between the two discharge destination groups (Home or Not Home). Significant factors were then included in multivariate logistic regression in order to determine the adjusted odds ratio for the discharge destination. A P value <.05 was taken as significant. Results 25 patients (64.1%) returned home. According to univariate analysis, NIHSS on admission and premorbid FAI were significantly associated with the discharge destination. Multivariate analysis found that NIHSS (OR, 0.71; 95% CI0.56–0.92; p = .008) and premorbid FAI (OR, 1.17; 95% CI1.03–1.33; p = .01) were independent predictors of the discharge destination. Conclusions Severity of stroke upon admission and premorbid IADL are associated with discharge destination following stroke.

Keywords: destination; discharge destination; following stroke; premorbid instrumental

Journal Title: eNeurologicalSci
Year Published: 2020

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