Background Hip fractures are high risk and high-impact events in the elderly population; despite orthopedic hip surgery, the disability and mortality rate remains significant. The National Health Insurance Agency in Taiwan established a fragility fracture PAC rehabilitation program to provide functional recovery for these patients after the surgery. However, the current literature on PAC rehabilitation is outdated, and there is an urgent need for the re-evaluation of the program. Methods This is a retrospective cohort study that enrolled 159 patients in the PAC rehabilitation program, followed by hip repair surgery. Outcome measures were the differences in participants’ pre- and post-PAC scores in 1) Barthel index, 2) Numerical Rating Scale (NRS), and 3) Harris Hip Scores (HHS) as surrogate indicators of the functional status, followed by the analysis of subgroups, including sex, age, site of the fracture, type of procedure, and the number of comorbidities. Results After completing PAC rehabilitation, 86.2% of the patients successfully returned to the community with either home or out-patient rehabilitation. The re-admission rate was 3.1% and 3.8% in 14-days and in 30-days follow up, respectively. The difference in pre- and post-Barthel index, NRS, and HHS showed significant improvement (p<0.001), without significant variations between the subgroups. Additionally, the Barthel index showed a positive correlation to HHS and a negative correlation to NRS. Conclusion This study revealed that the current form of post-surgery fragility fracture PAC program effectively improves functional status, reduces the re-admission rate, and facilitates the patient transition back to the community. The results should improve patients’ and physicians’ confidence in such a program.

Background Middle cerebral artery (MCA) ischemic stroke poses a major threat to human beings and prompts intravenous thrombolytic and/or thrombectomy management remains the gold standard treatment. However, not all MCA stroke patients fit in the inclusion and exclusion criteria that many patients only receive conventional medical therapy. We attempt to seek the baseline parameters that can effectively predict patients’ long-term functionality, as well as hypothesizing that the carotid duplex derived resistance/pulsatility index might be capable of fulfilling this purpose. Methods The 741 MCA ischemic stroke patients have been retrospectively recruited for the project. Under the initial screening, matching the inclusion and exclusion criteria, there are 471 participants to be enrolled in the study. The patients’ basic information, along with outcome assessments, pre-admission Barthel index and NIHSS score, and pre- and post-treatment mRS are recorded. All statistical analyses were performed using R for Windows (version 3.6.3). The significance level was set at P < 0.05 for all analyses. Results Of the 471 patients, 239 participants show a net mRS improvement, whereas the other 232 show deterioration. Hyperlipidaemia, chronic kidney disease, and dementia are related to long-term functionality improvement. The multivariate logistic regression analysis shows that right common carotid artery (CCA) resistance index (RI) and ischemic heart disease play a significant role in favourable outcome functionality. The ROC and Youden Index models are formulated, and it shows that Barthel Index and the NIHSS are most significant in the outcome measurement group (AUC: 0.675, 0.653; cut-off point: 57.5, 3.5, respectively). The right-side CCA RI is the solely important outcome predictor for the baseline carotid duplex study (AUC: 0.5; cut-off point: 0.785). Conclusion The favourable long-term functionality of MCA ischemic stroke patients receiving conventional medical treatment seems to correlate fairly with pre-admission NIHSS and Barthel index scores. Underlying hyperlipidaemia, chronic kidney disease, and dementia are conversely associated with favourable long-term capability. Moreover, the value of CCA RI appears to significantly alter the long-term outcomes in this group of patients.

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Background: According to a report from the World Health Organization, traumatic brain injury (TBI) will surpass many diseases by 2020 and become the main cause of death and disability. It is estimated that 10 million people are affected by TBI every year, and the burden of death and morbidity disease is imposed on society, making TBI urgent public health and medical problem (Hyder et al., 2007).In Taiwan, for every 100,000 emergency patients, there are 333 patients with traumatic brain injury, and the predominant group is 15-24 years old, and the mortality rate is 9 per 10,000.The survivors caused a lot of troubles in life because of the remaining obstacles, especially health and socio-economic problems (Wang et al., 2012).Therefore, post-acute care (PAC) is immediately given active integrated care during the golden period of post-acute care to restore its function, which will reduce the medical expenses of subsequent rehospitalization and reduce the burden of family and social care. Objective: The purpose of this study was to exploring the effectiveness of post -acute care for the patients with traumatic brain injury. Methods: This is a retrospective cohort study that enrolled 168 patients over 18 years of age (inclusive) about before and after PAC. The differences between the before and after receiving PAC were collected about the Barthel Index (ADL), Lawton-Brody IADL Scale (IADL), and EuroQoL-5D(EQ-5D) by using purposive sampling. The Statistics SPSS 25.0 package software was used to test the Paired Samples t-test, Pearson correlation coefficient, Chi-square Test for statistical analysis. Results: The results showed that this study predicts that the functional recovery of patients with traumatic brain injury receiving PAC treatment will be effective. The optimal length of hospitalization for rehabilitation was predicted by the Barthel Index(ADL), Lawton-Brody IADL Scale (IADL), and EuroQoL-5D(EQ-5D). Conclusion: The results of this study can confirm that PAC has important effects. This result can be used as a reference for national planning health policies and cross-disciplinary professional design cases and family PAC intervention plans, in order to restore activity functions as soon as possible, improve the quality of life, and reduce the burden of family and social care. Keywords: traumatic brain injury, Functional Status, Post-Acute Care (PAC) , Depression, Physical and mental condition