TY - JOUR
T1 - The interaction of aspiration pneumonia with demographic and cerebrovascular disease risk factors is predictive of discharge level of care in the acute stroke patient
AU - Ifejika-Jones, Nneka L.
AU - Harun, Nusrat
AU - Peng, Hui
AU - Noser, Elizabeth A.
AU - Grotta, James C.
AU - Francisco, Gerard E.
PY - 2012/2
Y1 - 2012/2
N2 - Ifejika-Jones NL, Harun N, Peng H, Noser EA, Grotta JC, Francisco GE: The interaction of aspiration pneumonia with demographic and cerebrovascular disease risk factors is predictive of discharge level of care in the acute stroke patient. Am J Phys Med Rehabil 2012;91:141Y147. Objective: This study aimed to evaluate factors that help determine the postacute level of care for stroke patients with aspiration pneumonia (ASPNA). Design: This was a retrospective observational study of patients admitted to the University of Texas at Houston Medical School Stroke Service between July 2004 and October 2009 with discharge dispositions of home, inpatient rehabilitation, skilled nursing facility, or subacute care (n = 3511). Demographics, stroke risk factors, and National Institutes of Health Stroke Scale (NIHSS) values were collected. Interactions were evaluated between ASPNA and aging, ASPNA and NIHSS, ASPNA and use of tube feeding, and ASPNA and history of stroke. Using multivariable logistic regression, the data were analyzed for differences in disposition among patients with ASPNA. Results: There were significant correlations between ASPNA and an NIHSS value of 7.44 or greater for discharge to inpatient rehabilitation, skilled nursing facility, or subacute care compared with discharge to home (P = 0.0138); between ASPNA and an NIHSS value of 10.93 or greater for discharge to skilled nursing facility or subacute care compared with inpatient rehabilitation (P<0.0001); and between ASPNA and age greater than 69.30 yrs for discharge to subacute care compared with a skilled nursing facility (P<0.0001). Conclusions: Patients with ASPNA and an NIHSS value of 7.44 or greater are more likely to require additional postacute care. ASPNA and an NIHSS value of 10.93 or greater increased the chance of postacute care at a level suggestive of lower functional status (skilled nursing facility or subacute care compared with inpatient rehabilitation). Age greater than 69.30 yrs plus ASPNA increased the likelihood of placement in subacute care vs. a skilled nursing facility.
AB - Ifejika-Jones NL, Harun N, Peng H, Noser EA, Grotta JC, Francisco GE: The interaction of aspiration pneumonia with demographic and cerebrovascular disease risk factors is predictive of discharge level of care in the acute stroke patient. Am J Phys Med Rehabil 2012;91:141Y147. Objective: This study aimed to evaluate factors that help determine the postacute level of care for stroke patients with aspiration pneumonia (ASPNA). Design: This was a retrospective observational study of patients admitted to the University of Texas at Houston Medical School Stroke Service between July 2004 and October 2009 with discharge dispositions of home, inpatient rehabilitation, skilled nursing facility, or subacute care (n = 3511). Demographics, stroke risk factors, and National Institutes of Health Stroke Scale (NIHSS) values were collected. Interactions were evaluated between ASPNA and aging, ASPNA and NIHSS, ASPNA and use of tube feeding, and ASPNA and history of stroke. Using multivariable logistic regression, the data were analyzed for differences in disposition among patients with ASPNA. Results: There were significant correlations between ASPNA and an NIHSS value of 7.44 or greater for discharge to inpatient rehabilitation, skilled nursing facility, or subacute care compared with discharge to home (P = 0.0138); between ASPNA and an NIHSS value of 10.93 or greater for discharge to skilled nursing facility or subacute care compared with inpatient rehabilitation (P<0.0001); and between ASPNA and age greater than 69.30 yrs for discharge to subacute care compared with a skilled nursing facility (P<0.0001). Conclusions: Patients with ASPNA and an NIHSS value of 7.44 or greater are more likely to require additional postacute care. ASPNA and an NIHSS value of 10.93 or greater increased the chance of postacute care at a level suggestive of lower functional status (skilled nursing facility or subacute care compared with inpatient rehabilitation). Age greater than 69.30 yrs plus ASPNA increased the likelihood of placement in subacute care vs. a skilled nursing facility.
KW - Aspiration pneumonia
KW - Outcomes
KW - Rehabilitation epidemiology
UR - http://www.scopus.com/inward/record.url?scp=84856321946&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84856321946&partnerID=8YFLogxK
U2 - 10.1097/PHM.0b013e31823caa8d
DO - 10.1097/PHM.0b013e31823caa8d
M3 - Article
C2 - 22355814
AN - SCOPUS:84856321946
SN - 0894-9115
VL - 91
SP - 141
EP - 147
JO - American Journal of Physical Medicine and Rehabilitation
JF - American Journal of Physical Medicine and Rehabilitation
IS - 2
ER -