Effects of Critical Pathway on the Start of Rehabilitation in Stroke Patients of Single University Hospital.

, Lim, Jong Youb; , Kang, Eun Kyoung; , Oh, Min Kyun; , Han, Moon Ku; , Kwon, O Ki; , Oh, Chang Wan; , Bae, Hee Joon; , Paik, Nam Jong

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2009;33(6):675-681.

Lim, Jong Youb , Kang, Eun Kyoung , Oh, Min Kyun , Han, Moon Ku , Kwon, O Ki , Oh, Chang Wan , Bae, Hee Joon , Paik, Nam Jong

¹Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Korea. njpaik@snu.ac.kr
²Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Korea.
³Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Korea.

일개 대학병원의 뇌졸중 환자 재활치료 시작에 대한 주임상경로의 효과

임종엽, 강은경, 오민균, 한문구¹, 권오기², 오창완², 배희준¹, 백남종

서울대학교 의과대학 분당서울대학교병원 재활의학과, ¹신경과, ²신경외과

Abstract

Objective
To evaluate the effects of rehabilitation-start critical pathway (Rehab-CP) based on modified Rankin scale (mRS) on stroke outcomes.
Method
We compared stroke outcome between before and after the carrying into effect of Rehab-CP by retrospective medical record review. First-onset stroke patients admitted to neurology department, and transferred to rehabilitation department were included in the analysis. Hospital length of stay (LOS), home discharge rate, functional outcome such as mRS, Brunnstrom stage, Korean version of modified Barthel index, Fugl-Meyer scale, mini-mental status examination, Berg Balance scale at discharge and 3 months after onset were analyzed.
Results
Thirty-nine patients before the commencement of Rehab-CP and 46 patients after the Rehab-CP were compared. Length of stay in neurology department were 2.5 days shorter in after Rehab-CP group as compared to before Rehab-CP group (p=0.056) and total LOS were 1.9 days shorter in after Rehab-CP group (p=0.485), although this did not reach statistical significant difference. There were no differences in home discharge rate, and other functional outcomes between two groups (p＞0.05).
Conclusion
Rehabilitation-start CP based on mRS may decrease LOS without affecting functional outcome, and this result primarily comes from the shortening of stay in neurology department before transfer to rehabilitation ward. (J Korean Acad Rehab Med 2009; 33: 675-681)

Key Words: Stroke, Critical pathway, Rehabilitation, Transfer