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dc.contributor.authorPérez, Laura M.
dc.contributor.authorInzitari, Marco
dc.contributor.authorQuinn, Terence J.
dc.contributor.authorMontaner, Joan
dc.contributor.authorGavaldà Mestre, Ricard
dc.contributor.authorDuarte, Esther
dc.contributor.authorColl Planas, Laura
dc.contributor.authorCerdá, Mercé
dc.contributor.authorSantaeugenia, Sebastia
dc.contributor.authorClosa, Conxita
dc.contributor.authorGallofre, Miquel
dc.contributor.otherUniversitat Politècnica de Catalunya. Departament de Ciències de la Computació
dc.date.accessioned2016-12-22T15:35:29Z
dc.date.available2016-12-22T15:35:29Z
dc.date.issued2016-11-09
dc.identifier.citationPérez, L., Inzitari, M., Quinn, T., Montaner, J., Gavaldà, R., Duarte, E., Coll, L., Cerdá, M., Santaeugenia, S., Closa, C., Gallofre, M. Rehabilitation profiles of older adult stroke survivors admitted to intermediate care units: A multi-centre study. "PLoS one", 9 Novembre 2016, vol. 11, núm. 11, p. 1-13.
dc.identifier.issn1932-6203
dc.identifier.urihttp://hdl.handle.net/2117/98769
dc.description.abstractBackground: Stroke is a major cause of disability in older adults, but the evidence around post-acute treatment is limited and heterogeneous. We aimed to identify profiles of older adult stroke survivors admitted to intermediate care geriatric rehabilitation units. Methods: We performed a cohort study, enrolling stroke survivors aged 65 years or older, admitted to 9 intermediate care units in Catalonia-Spain. To identify potential profiles, we included age, caregiver presence, comorbidity, pre-stroke and post-stroke disability, cognitive impairment and stroke severity in a cluster analysis. We also proposed a practical decision tree for patient’s classification in clinical practice. We analyzed differences between profiles in functional improvement (Barthel index), relative functional gain (Montebello index), length of hospital stay (LOS), rehabilitation efficiency (functional improvement by LOS), and new institutionalization using multivariable regression models (for continuous and dichotomous outcomes). Results: Among 384 patients (79.1±7.9 years, 50.8% women), we identified 3 complexity profiles: a) Lower Complexity with Caregiver (LCC), b) Moderate Complexity without Caregiver (MCN), and c) Higher Complexity with Caregiver (HCC). The decision tree showed high agreement with cluster analysis (96.6%). Using either linear (continuous outcomes) or logistic regression, both LCC and MCN, compared to HCC, showed statistically significant higher chances of functional improvement (OR = 4.68, 95%CI = 2.54–8.63 and OR = 3.0, 95%CI = 1.52–5.87, respectively, for Barthel index improvement =20), relative functional gain (OR = 4.41, 95%CI = 1.81–10.75 and OR = 3.45, 95%CI = 1.31–9.04, respectively, for top Vs lower tertiles), and rehabilitation efficiency (OR = 7.88, 95%CI = 3.65–17.03 and OR = 3.87, 95%CI = 1.69–8.89, respectively, for top Vs lower tertiles). In relation to LOS, MCN cluster had lower chance of shorter LOS than LCC (OR = 0.41, 95%CI = 0.23–0.75) and HCC (OR = 0.37, 95%CI = 0.19–0.73), for LOS lower Vs higher tertiles. Conclusion: Our data suggest that post-stroke rehabilitation profiles could be identified using routine assessment tools and showed differential recovery. If confirmed, these findings might help to develop tailored interventions to optimize recovery of older stroke patients.
dc.format.extent13 p.
dc.language.isoeng
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/es/
dc.subjectÀrees temàtiques de la UPC::Informàtica::Aplicacions de la informàtica
dc.subjectÀrees temàtiques de la UPC::Ciències de la salut::Medicina
dc.subject.lcshCerebrovascular disease -- Patients -- Rehabilitation
dc.subject.otherCluster-analysis
dc.subject.otherInpatient rehabilitation
dc.subject.otherDischarge destination
dc.subject.otherFunctional outcomes
dc.titleRehabilitation profiles of older adult stroke survivors admitted to intermediate care units: A multi-centre study
dc.typeArticle
dc.subject.lemacMalalties cerebrovasculars -- Pacients -- Rehabilitació
dc.contributor.groupUniversitat Politècnica de Catalunya. LARCA - Laboratori d'Algorísmia Relacional, Complexitat i Aprenentatge
dc.identifier.doi10.1371/journal.pone.0166304
dc.description.peerreviewedPeer Reviewed
dc.relation.publisherversionhttp://journals.plos.org/plosone/article?id=10.1371/journal.pone.0166304
dc.rights.accessOpen Access
local.identifier.drac19354028
dc.description.versionPostprint (published version)
local.citation.authorPérez, L.; Inzitari, M.; Quinn, T.; Montaner, J.; Gavaldà, R.; Duarte, E.; Coll, L.; Cerdá, M.; Santaeugenia, S.; Closa, C.; Gallofre, M.
local.citation.publicationNamePLoS one
local.citation.volume11
local.citation.number11
local.citation.startingPage1
local.citation.endingPage13
dc.identifier.pmid27829011


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