Long-Term Rehabilitation Outcomes of Neurological Patients: A Multicenter Study

Donruedee  Srisuppaphon; Pranee  Lukkanapichonchut; Nualpis  Intaratep; Vilai  Kuptniratsaikul

doi:10.33192/Smj.2022.67

Authors

Donruedee Srisuppaphon Sirindhorn National Medical Rehabilitation Institute, Ministry of Public Health
Pranee Lukkanapichonchut Department of Rehabilitation Medicine, Ratchaburi Hospital, Ministry of Public Health
Nualpis Intaratep Department of Rehabilitation Medicine, Maharat Nakhon Ratchasima Hospital, Ministry of Public Health
Vilai Kuptniratsaikul Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University

DOI:

https://doi.org/10.33192/Smj.2022.67

Keywords:

Rehabilitation, treatment outcome, inpatients, functions, multicenter study

Abstract

Objective: To evaluate functional outcomes in patients three years after rehabilitation and to identify factors significantly associated with improvement.
Materials and Methods: This prospective cohort study was carried out in nine tertiary centers to compare functional outcomes (Barthel Index; BI) at discharge with scores at three-year follow-up among various diagnoses and types of admissions. Related factors were evaluated for association with improvement in functional score.
Results: Three hundred and eighteen patients (mean age: 54 years; 60% male) were included. More than half of all patients suffered from a spinal cord injury. After three years, 35% of patients were still receiving physical therapy. Only those who were admitted for intensive rehabilitation showed significant improvement after three years. One hundred and ten patients or 35.8% showed significant improvement over time. A univariate analysis showed type of diagnosis, type of admission, onset to admission interval, BI at discharge, and presence of depression and complications at follow-up to be significantly associated with improvements in functional score in the follow-up period. Using a multivariate analysis, only the type of diagnosis, low BI at discharge, and absence of depression and complications at follow-up related to functional improvement.
Conclusion: One-third of patients had sustained functional improvements from rehabilitation three years after discharge. Participants admitted into intensive rehabilitation showed significant improvements in functional scores between discharge and follow-up. TBI diagnosis, low BI at discharge, absence of depression and complications at follow-up related to long-term functional improvement at the three-year mark.

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