Assessing stroke patients for rehabilitation during the acute hospitalization: findings from the get with the guidelines-stroke program.

OBJECTIVE: To examine the frequency and determinants of an assessment for rehabilitation during the hospitalization for acute stroke. DESIGN: Prospective cohort of patients admitted with acute stroke in the Get With The Guidelines-Stroke (GWTG-Stroke) program from January 8, 2008, to March 31, 2011. SETTING: Acute hospitals (n=1532) in the United States participating in the GWTG-Stroke program. PARTICIPANTS: Adults with a stroke diagnosis (N=616,982) from a GWTG-Stroke-participating acute hospital. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Documentation of an assessment for rehabilitation services during the acute hospitalization. RESULTS: Overall, almost 90% of stroke patients had documentation of an acute assessment for rehabilitation. In multivariable analysis, patients significantly more likely to be assessed for rehabilitation were younger, male, black or of other nonwhite races (Asian, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander) when compared with white, independently ambulating before admission, and admitted from the community. Patients who received a stroke consult, cared for in a stroke unit, and treated in the northeast region of the United States were also more likely to be assessed. CONCLUSIONS: There is evidence that rehabilitation was considered for 90% of acute stroke patients in this sample. Future research is needed to examine what assessments are conducted and by whom, and how these are used to determine the appropriate level of rehabilitation care for their needs.

Duke Scholars

Author Janet Prvu Bettger Orthopaedic Surgery