Cognitive Function as Predictor of Home Discharge in Stroke

The study covered in this summary was published in Research Square as a preprint and has not yet been peer reviewed.

Key Takeaways

• For patients with subacute stroke, assessing cognitive function at admission may be useful for predicting home discharge.

• There is a significant association between Mini–Mental State Examination (MMSE) score and home discharge for stroke patients.

Why This Matters

• Cognitive impairment is a common symptom of patients with stroke.

• Poststroke cognitive impairment has been reported to be associated with dependency and increased costs of care.

• This is the first study to investigate the relationship between home discharge and general cognitive impairment in subacute stroke patients in a multivariate analysis.

Study Design

• This retrospective cohort study included 1229 convalescent patients experiencing first subacute stroke.

• Scores on the following tests were recorded for each patient: MMSE, Stroke Impairment Assessment Set–Motor Function (SIAS-m), grip strength test, and Functional Independence Measure (FIM).

• A multivariate logistic regression analysis was performed to identify factors related to home discharge.

Key Results

• The factors at admission that were significantly associated with home discharge were age (P < .001), duration from stroke onset (P = .003), living situation (P < .001), MMSE score (P = .035), FIM motor score (P = .001), and FIM cognitive score (P < .001).

• The factors more likely to be associated with home discharge were younger age, male sex, cerebral infarction, right side of the brain being affected, and not living alone. For the patients with these factors, duration from stroke onset to admission was shorter, hospital duration was shorter, body mass index was greater, MMSE score was higher, SIAS-m score was higher, grip strength score was higher, and FIM score was higher than for those in the facility discharge group (P < .050).

Limitations

• Patients with disturbance of consciousness and aphasia or bilateral cerebral lesions were excluded from the study.

• Data related to the location of the brain lesion, such as stroke region or volume, were not collected.

• The severity of stroke was not assessed.

• The study was conducted in a single facility, which limits the generalizability of the results.

Disclosures

• The study conformed to the Declaration of Helsinki guidelines and was reviewed and approved by the Ethics Committee of Tokyo Bay Rehabilitation Hospital.

• The study was supported by AMED.

This is a summary of a preprint research study, “Cognitive Function is a Predictor of Home Discharge in Subacute Stroke Patients: A Retrospective Cohort Study,” written by Daisuke Ito from the Keio University School of Medicine and colleagues, publihsed on Research Square and provided to you by Medscape. This study has not yet been peer reviewed. The full text of the study can be found on researchsquare.com.

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