Association between rehabilitation frequency and stroke recurrence

• Main Authors: Yu-Tien Hsiao, 蕭育恬
• Other Authors: 王中儀
• Format: Others
• Language: zh-TW
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/11429075731346755513

碩士 === 中國醫藥大學 === 醫務管理學系碩士在職專班 === 100 === Background: Cerebrovascular disease, the third of the top ten leading causes of death in Taiwan in 2009, made great impacts on the medical cost and the load of health care. Prior research indicated that rehabilitation treatments might stabilize the physiological functions of patients and thus improve the activities of daily living. Rehabilitation may be linked to stroke recurrence. Objective: This study sought to explore the association between rehabilitation frequency and stroke recurrence among patients with stroke. Methods: With a retrospective cohort design, the current study analyzed the medical claims data extracted from 1,000,000 randomly sampled beneficiaries recorded in the 2002-2009 Taiwan National Health Insurance Research Database. A total of 18,517 patients diagnosed as stroke (ICD-9-CM: 430.xx-437.xx) were identified. Descriptive statistics, Chi-square, and logistic regression were conducted in SAS 9.1. The rehabilitation frequency was coded as high, medium high, medium low, and low by statistical quartile. Other factors associated with stroke recurrence were controlled in the multivariate models. Results: Of all the subjects, patients with ischemic and hemorrhage stroke account for 87.51% (16,205) and 12.49% (2,312) respectively. 46.77% (8,661) of the stroke patients received rehabilitation. Totally, 10.62% (1,967) suffered from recurrent strokes. Patients with rehabilitation were more likely to report stroke recurrence compared to those without. The factors significantly associated with recurrent stroke among patients receiving rehabilitation were gender, age, stroke type, comorbidity (including diabetes, atrial fibrillation, and chronic kidney disease), hospital level, hospital ownership, interval between first stroke and first rehabilitation, and rehabilitation frequency. The odds of stroke recurrence increased with each increment of rehabilitation frequency (P<.0001). Conclusions: This study found a positive relationship between rehabilitation frequency and stroke recurrence. Rehabilitation frequency can be an effective predictor for stroke recurrence. The association between rehabilitation frequency and stroke recurrence should be more valued. The potential causes of stroke recurrence under the high frequency of rehabilitation justify further research.