Outcome prediction in patients with putaminal hemorrhage at admission to a convalescent rehabilitation ward based on hemorrhage volume assessed with computed tomography during acute care.

[Purpose] The aim of this study was to assess the usefulness of computed tomography for outcome prediction in patients with putaminal hemorrhage at admission to a convalescent rehabilitation ward. [Participants and Methods] Patients admitted to our convalescent rehabilitation ward after transfer from acute care hospitals were included in this study. Multiple regression analyses were performed using the score in the motor component of the Functional Independence Measure at discharge as the target value. Hemorrhage volume assessed with computed tomography during acute care and age were set as the explanatory variables. The motor component of the Functional Independence Measure score at admission and the time (days) from onset were also recorded. Correlation analyses between all the possible pairs of explanatory variables were then performed. [Results] Hemorrhage volume and age were both significant contributors to the motor component of the Functional Independence Measure score at discharge. However, the contribution of hemorrhage volume disappeared when the time from onset and motor component of the Functional Independence Measure score at admission were added. Hemorrhage volume significantly correlated with the time from onset and motor component of the Functional Independence Measure score at admission. [Conclusion] The present findings suggest that computed tomography may be useful for outcome prediction from the acute stage in stroke patients with putaminal hemorrhage. However, because of multicollinearity, its predictive power was reduced when the patients were transferred to a convalescent rehabilitation ward.

Energy requirements for patients in convalescent rehabilitation using motor scores as in the Functional Independent Measure.

BACKGROUND AND OBJECTIVES: Although appropriate nutrition management could improve rehabilitation outcomes, more than 40 % of patients in a convalescent rehabilitation ward (CRW) suffer from malnutrition. The study was undertaken to investigate whether adequate nutrition for each patient in a CRW could be estimated based on motor scores on the Functional Independence Measure (FIM-M). METHODS AND STUDY DESIGN: In 218 patients in our CRW, both basal energy expenditure (BEE) on admission and average energy intake (EI) for 2 weeks were calculated, and EI was divided by BEE to estimate the activity index (e-AI). The patients were classified according to FIM-M to investigate the relationship between the FIM-M and the e-AI. RESULTS: The e-AI tended to increase in proportion to the FIM-M. In the N group, where the increase-decrease rate for body weight was within 2%, the e-AI induced by a FIM-M greater than 60 was significantly higher than that induced by a FIM-M up to 60 (1.3 vs 1.1, p<0.01). Compared to the N group, altering the e-AI caused the same tendency of body weight change in patients with FIM-M greater than 60 and up to 60. CONCLUSIONS: The FIM-M could provide a criterial activity index for patients in a CRW when their energy requirement is appropriately estimated, considering the intensity of their physical activity.