| Summary: | 碩士 === 國立陽明大學 === 醫務管理研究所 === 102 === Research purpose
Stroke patients can achieve reduced complications through rehabilitation and thereby achieve a better quality of life. However, there is still a lack of evidence supporting the correlation between early rehabilitation and stroke prognosis. The purpose of this research is to study the association between the timing of rehabilitation and immobility-related complications.
Research method
The research subjects are patients who were initially hospitalized due to stroke in the year 2005 and had complications within one year after the initial hospitalization, totaling 14,844 patients. A group-based trajectory model was used to analyze the correlation between early rehabilitation and stroke prognosis based on the complication data collected at different time points. The Odds Ratio (OR) test and the Confidence Interval (CI) of the relevant correlated variables, such as health status, was calculated by trajectory grouping and multinomial logistic regression after the adjustment of the variables; the relative risk of each group was further observed.
Research results
The categorization is based on the timing of the start of rehabilitation (within 7 days, more than 7 days, within 14 days, and more than 14 days after hospitalization.) The results indicated that patients who start rehabilitation earlier have a better chance of being in a group with decreasing complication occurrence. With every additional year of patient age, the patient has a lower chance of appearing in the decreasing complication occurrence group. The results also indicated that patients with milder stroke severity had a greater chance of appearing in the decreasing complication occurrence groups and that ischemic stroke patients are more likely to appear in the decreasing complication occurrence group than hemorrhagic stroke patients. Additionally, the existence of hypertension, diabetes, and high cholesterol among the comorbidities partially influences the grouping of complication occurrence (multinomial logistic regression analysis showing significant correlation).
Conclusion
Rehabilitation within 7 days of hospitalization is related to immobility-related complications. Younger patients, patients with milder stroke severity, and ischemic stroke patients have reduced complication occurrence. With regard to comorbidities, there is an influence of the presence or absence of hypertension in the lower occurrence group. Comparing the lower and higher complication occurrence groups, diabetes has positive impact, while high cholesterol has negative impact.
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