skip to content
Initial physical grades and cognitive stages after acute stroke: who receives comprehensive rehabilitation services?
ClosePreview this item
Checking...

Initial physical grades and cognitive stages after acute stroke: who receives comprehensive rehabilitation services?

Author: MG Stineman Affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA; Department of Physical Medicine and Rehabilitation, University of Pennsylvania, 423 Guardian Drive, 904 Blockley Hall, Philadelphia, PA 19104-6021(∗). Electronic address: mstinema@exchange.upenn.edu.BE Bates Affiliation: Physical Medicine and Rehabilitation, Veterans Affairs Medical Center, Albany, NY; Physical Medicine and Rehabilitation, Albany Medical College, Albany, NY(†).JE Kurichi Affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA(‡).PL Kwong Affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA(§).DC Ripley Affiliation: Veterans Affairs Health Services Research & Development/Rehabilitation Research and Development Rehabilitation Outcomes Research Center Research Enhancement Award Program North Florida/South Georgia Veterans Health System, Gainesville, FL; Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL(¶).All authors
Edition/Format: Article Article : English
Publication:PM & R : the journal of injury, function, and rehabilitation, 2013 Dec; 5(12): 1007-18
Summary:
OBJECTIVES: To study the degree to which initial physical grades and cognitive stages of independence assessed by physical medicine and rehabilitation (PM&R) staff early after hospitalization for acute stroke relate to the decision to either provide rehabilitation in consultation or admission to a specialized rehabilitation unit (SRU) for comprehensive, high-intensity, multidisciplinary rehabilitation. DESIGN: An  Read more...
Rating:

(not yet rated) 0 with reviews - Be the first.

&AllPage.SpinnerRetrieving;

Find a copy online

Links to this journal/publication

Find a copy in the library

&AllPage.SpinnerRetrieving; Finding libraries that hold this item...

Details

Document Type: Article
All Authors / Contributors: MG Stineman Affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA; Department of Physical Medicine and Rehabilitation, University of Pennsylvania, 423 Guardian Drive, 904 Blockley Hall, Philadelphia, PA 19104-6021(∗). Electronic address: mstinema@exchange.upenn.edu.; BE Bates Affiliation: Physical Medicine and Rehabilitation, Veterans Affairs Medical Center, Albany, NY; Physical Medicine and Rehabilitation, Albany Medical College, Albany, NY(†).; JE Kurichi Affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA(‡).; PL Kwong Affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA(§).; DC Ripley Affiliation: Veterans Affairs Health Services Research & Development/Rehabilitation Research and Development Rehabilitation Outcomes Research Center Research Enhancement Award Program North Florida/South Georgia Veterans Health System, Gainesville, FL; Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL(¶).; WB Vogel Affiliation: Veterans Affairs Medical Center Gainesville, FL; Division of Health Policy and Outcomes Research, Department of Epidemiology and Health Policy Research(‖).; D Xie Affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA(∗∗).
ISSN:1934-1482
Language Note: English
Unique Identifier: 5534449651
Awards:

Abstract:

OBJECTIVES: To study the degree to which initial physical grades and cognitive stages of independence assessed by physical medicine and rehabilitation (PM&R) staff early after hospitalization for acute stroke relate to the decision to either provide rehabilitation in consultation or admission to a specialized rehabilitation unit (SRU) for comprehensive, high-intensity, multidisciplinary rehabilitation. DESIGN: An observational study. SETTING: Early rehabilitation assessment by PM&R staff during patients' acute hospitalization for stroke in 112 Veterans Affairs facilities. PATIENTS: The sample included 8,783 veterans who were assessed by PM&R staff. METHODS: Shortly after hospital admission, functional status was determined according to 7 physical grades and 7 cognitive stages of increasing independence. Patients' physical grades and cognitive stages ranged at initial PM&R assessment from the lowest and most dependent "I" through intermediate "II, III, IV, V, or VI," and ended with the highest at total independence "VII." To assess the statistically independent effects of physical grade and cognitive stage, a multivariable generalized estimating equation was applied to account for within Veterans Affairs facilities correlation and to adjust for demographics, stroke type, comorbidities, clinical events before PM&R assessment, and facility-related factors. MAIN OUTCOME MEASUREMENTS: The decision to admit patients to an SRU for comprehensive rehabilitation. RESULTS: Only 11.2% of those patients assessed after stroke were admitted to an SRU after the acute management phase. After statistical adjustment, patients at the lowest physical grade (I) of independence had a 9-fold increased odds of admission to an SRU compared with those at the highest combined physical grades VI/VII (adjusted odds ratio 9.15, 95% confidence interval 4.31-19.39). In contrast, patients at intermediate cognitive stages of independence were the most likely to be admitted to an SRU. The presence of an SRU within the treating Veterans Affairs facility was strongly related to admission. CONCLUSIONS: Patients' physical grades and cognitive stages assessed early after stroke are strong determinants of referral for comprehensive rehabilitation.

Reviews

User-contributed reviews
Retrieving GoodReads reviews...
Retrieving DOGObooks reviews...

Tags

Be the first.
Confirm this request

You may have already requested this item. Please select Ok if you would like to proceed with this request anyway.

Linked Data


Primary Entity

<http://www.worldcat.org/oclc/5534449651> # Initial physical grades and cognitive stages after acute stroke: who receives comprehensive rehabilitation services?
    a schema:CreativeWork, schema:Article ;
    library:oclcnum "5534449651" ;
    rdfs:comment "949 $l Research Support, U.S. Gov't, Non-P.H.S." ;
    rdfs:comment "949 $l Journal Article" ;
    rdfs:comment "949 $l Research Support, U.S. Gov't, P.H.S." ;
    rdfs:comment "949 $l Research Support, Non-U.S. Gov't" ;
    schema:about <http://experiment.worldcat.org/entity/work/data/17105655#Topic/patient_acuity> ; # Patient Acuity
    schema:about <http://experiment.worldcat.org/entity/work/data/17105655#Topic/patient_selection> ; # Patient Selection
    schema:about <http://experiment.worldcat.org/entity/work/data/17105655#Topic/hospitalization> ; # Hospitalization
    schema:contributor <http://experiment.worldcat.org/entity/work/data/17105655#Person/bates_be> ; # Bates BE
    schema:contributor <http://experiment.worldcat.org/entity/work/data/17105655#Person/kurichi_je> ; # Kurichi JE
    schema:contributor <http://experiment.worldcat.org/entity/work/data/17105655#Person/ripley_dc> ; # Ripley DC
    schema:contributor <http://experiment.worldcat.org/entity/work/data/17105655#Person/vogel_wb> ; # Vogel WB
    schema:contributor <http://experiment.worldcat.org/entity/work/data/17105655#Person/xie_d> ; # Xie D
    schema:contributor <http://experiment.worldcat.org/entity/work/data/17105655#Person/kwong_pl> ; # Kwong PL
    schema:creator <http://experiment.worldcat.org/entity/work/data/17105655#Person/stineman_mg> ; # Stineman MG
    schema:description "SETTING: Early rehabilitation assessment by PM&R staff during patients' acute hospitalization for stroke in 112 Veterans Affairs facilities." ;
    schema:description "DESIGN: An observational study." ;
    schema:description "PATIENTS: The sample included 8,783 veterans who were assessed by PM&R staff." ;
    schema:description "MAIN OUTCOME MEASUREMENTS: The decision to admit patients to an SRU for comprehensive rehabilitation." ;
    schema:description "RESULTS: Only 11.2% of those patients assessed after stroke were admitted to an SRU after the acute management phase. After statistical adjustment, patients at the lowest physical grade (I) of independence had a 9-fold increased odds of admission to an SRU compared with those at the highest combined physical grades VI/VII (adjusted odds ratio 9.15, 95% confidence interval 4.31-19.39). In contrast, patients at intermediate cognitive stages of independence were the most likely to be admitted to an SRU. The presence of an SRU within the treating Veterans Affairs facility was strongly related to admission." ;
    schema:description "CONCLUSIONS: Patients' physical grades and cognitive stages assessed early after stroke are strong determinants of referral for comprehensive rehabilitation." ;
    schema:description "OBJECTIVES: To study the degree to which initial physical grades and cognitive stages of independence assessed by physical medicine and rehabilitation (PM&R) staff early after hospitalization for acute stroke relate to the decision to either provide rehabilitation in consultation or admission to a specialized rehabilitation unit (SRU) for comprehensive, high-intensity, multidisciplinary rehabilitation." ;
    schema:description "METHODS: Shortly after hospital admission, functional status was determined according to 7 physical grades and 7 cognitive stages of increasing independence. Patients' physical grades and cognitive stages ranged at initial PM&R assessment from the lowest and most dependent "I" through intermediate "II, III, IV, V, or VI," and ended with the highest at total independence "VII." To assess the statistically independent effects of physical grade and cognitive stage, a multivariable generalized estimating equation was applied to account for within Veterans Affairs facilities correlation and to adjust for demographics, stroke type, comorbidities, clinical events before PM&R assessment, and facility-related factors." ;
    schema:exampleOfWork <http://worldcat.org/entity/work/id/17105655> ;
    schema:isPartOf <http://worldcat.org/issn/1934-1482#5_12> ;
    schema:name "Initial physical grades and cognitive stages after acute stroke: who receives comprehensive rehabilitation services?" ;
    schema:pageStart "1007" ;
    schema:productID "5534449651" ;
    schema:sameAs <http://dx.doi.org/10.1016/j.pmrj.2013.08.598> ;
    wdrs:describedby <http://www.worldcat.org/title/-/oclc/5534449651> ;
    .


Related Entities

<http://experiment.worldcat.org/entity/work/data/17105655#Topic/patient_selection> # Patient Selection
    a schema:Intangible ;
    schema:name "Patient Selection" ;
    .

<http://worldcat.org/issn/1934-1482>
    a schema:Periodical ;
    rdfs:label "PM & R : the journal of injury, function, and rehabilitation" ;
    schema:issn "1934-1482" ;
    .

<http://www.worldcat.org/title/-/oclc/5534449651>
    a genont:InformationResource, genont:ContentTypeGenericResource ;
    schema:about <http://www.worldcat.org/oclc/5534449651> ; # Initial physical grades and cognitive stages after acute stroke: who receives comprehensive rehabilitation services?
    schema:dateModified "2016-08-01" ;
    void:inDataset <http://purl.oclc.org/dataset/medline> ;
    .


Content-negotiable representations

Close Window

Please sign in to WorldCat 

Don't have an account? You can easily create a free account.