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Outcome Prediction for Patients With Ischemic Stroke in Acute Care: New Three-Level Model by Eating and Bladder Functions

OBJECTIVE: To develop a new prediction model by combining independence in eating and bladder management functions, and to assess its utility in an acute care setting. METHODS: Patients with ischemic stroke who were admitted in our acute stroke care unit (n=250) were enrolled in this study. Functiona...

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Autores principales: Uchida, Kensaku, Uchiyama, Yuki, Domen, Kazuhisa, Koyama, Tetsuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Academy of Rehabilitation Medicine 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8273726/
https://www.ncbi.nlm.nih.gov/pubmed/34126671
http://dx.doi.org/10.5535/arm.20226
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author Uchida, Kensaku
Uchiyama, Yuki
Domen, Kazuhisa
Koyama, Tetsuo
author_facet Uchida, Kensaku
Uchiyama, Yuki
Domen, Kazuhisa
Koyama, Tetsuo
author_sort Uchida, Kensaku
collection PubMed
description OBJECTIVE: To develop a new prediction model by combining independence in eating and bladder management functions, and to assess its utility in an acute care setting. METHODS: Patients with ischemic stroke who were admitted in our acute stroke care unit (n=250) were enrolled in this study. Functional Independence Measure (FIM) scores for eating and bladder management on the initial day of rehabilitative treatment (median, 3 days) were collected as predictive variables. These scores were divided into low (<5) and high (≥5) and categorized as values 0 and 1, respectively. From the simple summation of these two-level model values, we derived a three-level model that categorized the scores as values 0, 1, and 2. The FIM-motor scores at discharge (median, 14 days) were collected as outcome measurements. The three-level model was assessed by observing the distribution patterns of the outcome FIM-motor scores and logistic regression analyses. RESULTS: The median outcome FIM-motor score was 19 (interquartile range [IQR],13.8–45.3) for the value 0 category (n=14), 66.5 (IQR, 59.5–81.8) for the value 1 category (n=16), and 84 (IQR, 77–89) for the value 2 category (n=95) in the three-level model. Data fitting by logistic regression for FIM-motor scores of 41.3 and 61.4 reached 50% probability of values 1 and 2, respectively. CONCLUSION: Despite the simplicity of the three-level model, it may be useful for predicting outcomes of patients with ischemic stroke in acute care.
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spelling pubmed-82737262021-07-26 Outcome Prediction for Patients With Ischemic Stroke in Acute Care: New Three-Level Model by Eating and Bladder Functions Uchida, Kensaku Uchiyama, Yuki Domen, Kazuhisa Koyama, Tetsuo Ann Rehabil Med Original Article OBJECTIVE: To develop a new prediction model by combining independence in eating and bladder management functions, and to assess its utility in an acute care setting. METHODS: Patients with ischemic stroke who were admitted in our acute stroke care unit (n=250) were enrolled in this study. Functional Independence Measure (FIM) scores for eating and bladder management on the initial day of rehabilitative treatment (median, 3 days) were collected as predictive variables. These scores were divided into low (<5) and high (≥5) and categorized as values 0 and 1, respectively. From the simple summation of these two-level model values, we derived a three-level model that categorized the scores as values 0, 1, and 2. The FIM-motor scores at discharge (median, 14 days) were collected as outcome measurements. The three-level model was assessed by observing the distribution patterns of the outcome FIM-motor scores and logistic regression analyses. RESULTS: The median outcome FIM-motor score was 19 (interquartile range [IQR],13.8–45.3) for the value 0 category (n=14), 66.5 (IQR, 59.5–81.8) for the value 1 category (n=16), and 84 (IQR, 77–89) for the value 2 category (n=95) in the three-level model. Data fitting by logistic regression for FIM-motor scores of 41.3 and 61.4 reached 50% probability of values 1 and 2, respectively. CONCLUSION: Despite the simplicity of the three-level model, it may be useful for predicting outcomes of patients with ischemic stroke in acute care. Korean Academy of Rehabilitation Medicine 2021-06 2021-06-14 /pmc/articles/PMC8273726/ /pubmed/34126671 http://dx.doi.org/10.5535/arm.20226 Text en Copyright © 2021 by Korean Academy of Rehabilitation Medicine https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Uchida, Kensaku
Uchiyama, Yuki
Domen, Kazuhisa
Koyama, Tetsuo
Outcome Prediction for Patients With Ischemic Stroke in Acute Care: New Three-Level Model by Eating and Bladder Functions
title Outcome Prediction for Patients With Ischemic Stroke in Acute Care: New Three-Level Model by Eating and Bladder Functions
title_full Outcome Prediction for Patients With Ischemic Stroke in Acute Care: New Three-Level Model by Eating and Bladder Functions
title_fullStr Outcome Prediction for Patients With Ischemic Stroke in Acute Care: New Three-Level Model by Eating and Bladder Functions
title_full_unstemmed Outcome Prediction for Patients With Ischemic Stroke in Acute Care: New Three-Level Model by Eating and Bladder Functions
title_short Outcome Prediction for Patients With Ischemic Stroke in Acute Care: New Three-Level Model by Eating and Bladder Functions
title_sort outcome prediction for patients with ischemic stroke in acute care: new three-level model by eating and bladder functions
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8273726/
https://www.ncbi.nlm.nih.gov/pubmed/34126671
http://dx.doi.org/10.5535/arm.20226
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