Background:Research focusing on predictors for discharge destination after
rehabilitation of inpatients recovering from severe stroke is scarce. The
predictive value of rehabilitation admission NIHSS score among other
potential predictors available on admission to rehabilitation has not been
studied.Aim:The aim of this retrospective interventional study was to determine the
predictive accuracy of 24 hours and rehabilitation admission NIHSS scores
among other potential socio-demographic, clinical and functional predictors
for discharge destination routinely collected on admission to
rehabilitation.Material and Methods:On a university hospital specialized inpatient rehabilitation ward 156
consecutive rehabilitants with 24 hours NIHSS score ⩾15 were recruited. On
admission to rehabilitation, routinely collected variables potentially
associated with discharge destination (community vs institution) were
analyzed using logistic regression.Results:70 (44.9%) of rehabilitants were discharged to community, and 86 (55.1%) were
discharged to institutional care. Those discharged home were younger and
more often still working, had less often dysphagia/tube feeding or DNR
decision in the acute phase, shorter time from stroke onset to
rehabilitation admission, less severe impairment (NIHSS score, paresis,
neglect) and disability (FIM score, ambulatory ability) on admission, and
faster and more significant functional improvement during the in-stay than
those institutionalized.Conclusion:The most influential independent predictors for community discharge on
admission to rehabilitation were lower admission NIHSS score, ambulatory
ability and younger age, NIHSS being the most powerful. The odds of being
discharged to community decreased with 16.1% for every 1 point increase in
NIHSS. The 3-factor model explained 65.7% of community discharge and 81.9%
of institutional discharge, the overall predictive accuracy being 74.7%. The
corresponding figures for admission NIHSS alone were 58.6%, 70.9% and
65.4%.