PREDICTING DISCHARGE DESTINATION OF STROKE PATIENTS USING A MATHEMATICAL-MODEL BASED ON 6 ITEMS FROM THE FUNCTIONAL INDEPENDENCE MEASURE

Objective: A mathematical model using selected items from the Function al Independence Measure (FIM) was developed to predict disposition of stroke patients from an acute care hospital. Design: Case series of 27 9 acute stroke patients admitted to the hospital from 4/91 through 12/ 93. Data collection remains ongoing; a second series of patients will be analyzed to validate results and determine if the same 6 FIM items are significant. Setting: Tertiary care center, general acute care com munity hospital. Patients: Diagnosis of acute stroke; 298 patients who se attending physician referred the patient to the rehabilitation team . An 18-item FIM was administered within 3 days of admission and 24 ho urs of discharge. Main Outcome Measure: FIM scores were analyzed to de termine if the initial score could be used to predict disposition. Dis criminant analysis identified 6 items as being statistically significa nt in predicting discharge to home, rehabilitation facility, or nursin g home. Patient's actual discharge location was compared with the loca tion predicted by the model developed using the FIM. Results: Bathing, bowel, toileting, social interaction, dressing lower body, and eating were the selected initial FIM items that predicted disposition with 7 0% accuracy in our patient series. Conclusion: The FIM is effective in the acute care setting to help determine appropriate discharge status , with certain variables being more predictive than others. (C) 1996 b y the American Congress of Rehabilitation Medicine and the American Ac ademy of Physical Medicine and Rehabilitation