Retrospective Assessment of the Implementation of Critical Pathway in Stroke Patients in a Single University Hospital.
10.5535/arm.2014.38.5.603
- Author:
Jin Hoan KIM
1
;
Ha Young BYUN
;
Seungnam SON
;
Joong Hoon LEE
;
Chul Ho YOON
;
Eun Shin LEE
;
Heesuk SHIN
;
Min Kyun OH
Author Information
1. Department of Rehabilitation Medicine, Gyeongsang National University Hospital, Jinju, Korea. solioh21@naver.com
- Publication Type:Original Article
- Keywords:
Stroke;
Rehabilitation;
Complications;
Critical pathways
- MeSH:
Critical Pathways*;
Deglutition Disorders;
Demography;
Heart Valve Diseases;
Hospitalization;
Humans;
Inpatients;
Length of Stay;
Lower Extremity;
Osteoarthritis;
Rehabilitation;
Rehabilitation Centers;
Retrospective Studies*;
Shoulder Pain;
Stroke*
- From:Annals of Rehabilitation Medicine
2014;38(5):603-611
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To evaluate the effects of the implementation of critical pathway (CP) in stroke patients treated at a single university hospital. METHODS: A retrospective medical review collected data from 497 patients who had suffered acute stroke in the rehabilitation center. Stroke outcomes were compared between before and after the implementation of CP based on factors including demographic factors, stroke characteristics, pre-existing medical conditions, medical complications, functional states, and length of stay (LOS). RESULTS: After the implementation of CP, the patients showed significantly higher stage for upper proximal (p=0.008) and lower extremity (p=0.001) on Brunnstrom stage and significantly lower scores for modified Rankin Scale (p=0.003) at transfer. For those with pre-existing medical conditions, there were significantly increased osteoarthritis (p=0.002) and valvular heart disease (p=0.011). Regarding medical complications during acute inpatient rehabilitation, there were significantly decreased shoulder pain (p=0.001) and dysphagia (p=0.017), and significantly increased gastrointestinal symptoms (p=0.001). Functional gain and efficiency of stroke patients during rehabilitation center hospitalization did not significantly change after implementation of CP. But, shorter LOS of total hospitalization, pre-rehabilitation center hospitalization, and rehabilitation center hospitalization were evident. CONCLUSION: After the implementation of CP, patients less often developed complications and displayed no changes in functional gain and efficiency. They had shorter LOS of total hospitalization, pre-rehabilitation center hospitalization and rehabilitation center hospitalization.
