The role of the functional independence measure score in predicting the home discharge of inpatients with cerebrovascular diseases in convalescent rehabilitation wards

Abstract

To clarify the cutoff point of the Functional Independence Measure tool for predicting home discharge of patients in convalescent rehabilitation wards. [Participants and Methods] This retrospective observational study analyzed the data of 91 inpatients with cerebrovascular disease who received rehabilitation treatment at a convalescent rehabilitation ward. We categorized the participants into two groups: the home-discharged group and the non-home discharged group. We divided the outcome parameters in the two groups into different categories and compared them using the Mann-Whitney U test. To identify the relevant cutoff points in a clinical setting, we applied the receiver operating characteristic curve. [Results] In patients with cerebrovascular disease, the Functional Independence Measure motor, cognitive, and total scores were significantly higher in the home-discharged group than in the non-home discharged group. We statistically calculated the Functional Independence Measure motor score cutoff point that can predict home discharge, and the predicted Functional Independence Measure motor score at the time of hospitalization was 53.5-60.0 points. [Conclusion] It is important to start rehabilitation at an early stage and increase the amount of training to increase the likelihood of returning home.

Clarification of Factors Determining Discharge Destination Among Elderly Patients After Stroke With Low Levels of Independence in Activities of Daily Living: A Retrospective Study

“…Several studies presented cut-off scores between home and other living situations based on the receiver operating characteristic curve. 18 , 19 , 20 Reistetter et al (2010) reported that the T-FIM score of 78 at discharge rating was the cut-off score. 18 We did not applya receiver operating characteristic curve; however, another method must be used to stratify patients into the home- and LCF-discharged group.…”

Conceptual changes needed to improve outcomes in rehabilitation medicine: A clinical commentary

“…A corollary of adopting the above goals as strategic goals of rehabilitation is that admission to rehabilitation should be based on the expected advantages of treatment in prolonging survival and achieving maximum ability realization. These goals are not part of the criteria for admission to rehabilitation services today, and present criteria for rehabilitation could be met, with a relatively small investment, by well-furnished nursing homes ( Stefanacci, 2015; Kessler, 2022 ; Good shepherd, 2022; Medicare, 2022 ). Only a critical mass of physiatrists and a multidisciplinary team that have the ability to translate the physicians’ knowledge and experience into care that maximizes survival and ability realization, as defined above, make a difference between a specialized rehabilitation ward and a well-furnished nursing home.…”

“…They may focus on procedures that shorten the LOS in rehabilitation or on reducing the burden of care (Miyoshi, 2018;Karahan, 2014). Many rehabilitation plans aim at the highest FIM score, which signals the lowest burden of care (Maritz, 2019;Shirahama, 2020). Caregivers who believe that they are doing so for the benefit of the patient, probably share the underlying belief that reducing the burden of care and shortening LOS in rehabilitation represent the universal interest or desire of rehabilitation patients.…”

Association between oral health status and functional independence measure on admission in convalescent hospitalized patients

“…Convalescent hospitals play an essential role in connecting the acute phase with the living phase. Convalescent hospitals restore independence through intensive rehabilitation so patients can return to their homes or nursing homes and live independently [ 3 ]. It is said that the appropriate time for discharge from a convalescent hospital is when the patient becomes independent in activities of daily living (ADL) or when there is no improvement in function despite training [ 4 , 5 ].…”