Authors (including presenting author) :
Wong HL (1), Chung PH (1), Lau FO (1)
Affiliation :
(1) Physiotherapy Department, Tai Po Hospital
Introduction :
Stroke Registry, as a database, is essential to provide information for continuous quality improvement in stroke rehabilitation service. It can help service model review, clinical decision support and outcome prediction. In the past, stroke outcome analysis was mainly focused on inpatient setting and that of community rehabilitation might be overlooked. While the golden period of stroke rehabilitation is within 3-6 months, it is important to analyze outcomes for the whole patient journey to complete the picture.
Objectives :
To monitor stroke outcomes from inpatient to Geriatric Day Hospital (GDH) in Tai Po Hospital (TPH).
Methodology :
1. Stroke Registry was developed to link inpatient and GDH’s stroke data. 2. Stroke patients with inpatient stay from Aug 2019 to Aug 2022 and GDH rehabilitation from Sep 2019 to Nov 2022 in TPH were included for outcome analysis.
Result & Outcome :
78 stroke patients were included. The mean age was 64.5 and the mean premorbid MFAC was 6.83. The mean length of whole patient journey in TPH was 160 days and the mean numbers of training days in both inpatient and GDH were 27.6. 13 patients who dropped out or had incomplete data were excluded for functional outcome analysis. Significant improvement of functional outcomes was found in both inpatient and GDH rehab but improvement in inpatient was greater than that of GDH as the recovery gradually plateaued (mean gain in inpatient: Modified Rivermead Mobility Index (MRMI) 10.4, Modified Functional Ambulatory Category (MFAC) 1.37, Berg Balance Scale (BBS) 14.4; mean gain in GDH: MRMI 4.02, MFAC 1.11, BBS 9.03). Gait was also significantly improved in GDH rehab with mean Wisconsin Gait Scale (WGS) difference of 2.92. For the window period between inpatient discharge and start of GDH rehab, mild improvement was only found in MRMI (1.54), MFAC (0.48) and BBS (3.95) but not WGS (-0.67). All in all, it is beneficial to have GDH rehab especially for gait training.
