Poster 1: A Survey: Where Did Patients Go After Stroke in the Beijing Area?
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in the hemiplegic-side bone marrow. Also, the stroke group after the primary culture showed an increased number of TRAP positive cells and a higher degree of bone resorption estimated by OAASTM plate. Conclusions: Osteoclastogenesis and osteoclast differen- tiation in the hemiplegic-side bone marrow increased along with bone resorption in the early stages of stroke. Poster 445 Urinary Tract Infection Is a Negative Predictor of Poststroke Disposition: Findings From the UTHSC Houston Stroke Registry. Nneka L. Ifejika-Jones, MD, MPH (UTHSC—Hous- ton, Houston, TX); Gerard E. Francisco, MD; James C. Grotta; Nusrat Harun, MSPH. Disclosures: N. L. Ifejika-Jones, None. Objective: To determine whether urinary tract infection (UTI) is a predictor of disposition in patients with acute stroke. Design: Retrospective observational study of prospectively collected data from patients admitted to the UTHSC Houston Stroke Service. Setting: Single university-based hospital. Participants: All patients admitted between January 2004 and October 2009 were included (n3390). Stratification occurred for age65 years, NIHSS, and stroke risk factors. Interventions: Low NIHSS (8) is an established predic- tor of higher functional status at discharge. We assessed the hypothesis that absence of UTI predicts poststroke disposi- tion to a functional level similar to low NIHSS. Main Outcome Measures: By using multivariate logis- tic regression, the data were analyzed for differences in post- stroke disposition among patients without UTI. Odds ratio (OR) was calculated to determine the likelihood of discharge to each level of care: home, inpatient rehabilitation (IR), skilled nursing facility (SNF), or subacute care (Sub). Results: Home versus other (IR, SNF, Sub): Of 3390 pa- tients, 1668 were discharged home, 1722 to another level of care. Patients without UTI are 2.5 times more likely to be discharged home (P .0001, OR 2.571 [95% CI, 1.831- 3.611]). Patients with NIHSS 8 are 16.3 times more likely to be discharged home. IR versus SNF: Of 1547 patients, 983 patients were discharged to IR, 564 to SNF. Patients without UTI are 1.9 times more likely to be discharged to IR (P.0001, OR 1.962 [95% CI, 1.391-2.768]). Patients with NIHSS 8 are 3.7 times more likely to be discharged to IR. SNF versus Sub: Of 739 patients, 564 were discharged to SNF, 175 to Sub. There were no significant differences in disposition among patients without UTI. Conclusions: Acute stroke patients without UTI are 2.5 times more likely to be discharged home. If poststroke reha- bilitation is needed, then patients without UTI are 1.9 times more likely to be admitted to IR versus SNF. This study is limited by its retrospective nature and the undetermined role of psychosocial factors related to discharge. Prospective stud- ies are warranted on the efficacy of early catheter discontin- uation after stroke and structured catheter care every shift by nursing. SCIENTIFIC POSTER PRESENTATIONS ADMINISTRATION Poster 1 A Survey: Where Did Patients Go After Stroke in the Beijing Area? Dong Yan (In-tech Rehabilitation Hospital, Beijing, China); Hu W. Li. Disclosures: D. Yan, None. Objective: To investigate where did the patients who suf- fered stroke transfer after the inpatient therapy in the big general hospital in Beijing. It is part of the pilot of Three Level Patients Transfer Network of Beijing Municipal Health Bureau. Design: Retrospective study. Setting: A standard questionnaire procedure. Participants: Followed-up 292 patients who had a stroke and underwent inpatient therapy at the Neurology Depart- ment of Chaoyang Hospital of Capital Medical University during September to November 2009. Interventions: Select the patients after stroke at the Neu- rology Department of the general hospital, Chaoyang Hospi- tal. Record the inpatient days and the hospital where the patients will transfer to. Telephone follow-up obtained in 1 month. Main Outcome Measures: R: indicates the patients transfer to a special rehabilitation hospital; T: indicates the patients transfer to a Chinese traditional hospital; H: indi- cates the patients transfer directly to home; G: indicates the patients transfer to other general hospital. Results: The average inpatient stay at Chaoyang was about 12 days. After the inpatient therapy in Chaoyang hospital, transfers were R: 26 (8.9%); T: 109 (37.3%); G: 31 (10.6%); H: 126 (43.2%). 1 month follow-up were: 17 (5.8%); T: 96 (32.9%); G: 12 (4.1%); H: 167 (57.2%). Conclusions: The patients after stroke in a big general hospital were mainly transferred to sublevel Chinese tradi- tional hospital. Rehabilitation beds were heavily deficient in Beijing. The efficiency of the big general hospital should be improved. Poster 2 A System Redesign Approach to Improving Timeliness of New Outpatient PM&R Consults: Veterans Affairs Observational Analysis and System Redesign. Ankur D. Mehta, DO, MBA (Loyola Medical Center Chicago, Chicago, IL); Sung Ahn, DO; Walter C. Damper, DO; Danilo Hipolito. S9 PM&R Vol. 2, Iss. 9S, 2010
Transcript of Poster 1: A Survey: Where Did Patients Go After Stroke in the Beijing Area?
in the hemiplegic-side bone marrow. Also, the stroke groupafter the primary culture showed an increased number ofTRAP positive cells and a higher degree of bone resorptionestimated by OAASTM plate.Conclusions: Osteoclastogenesis and osteoclast differen-tiation in the hemiplegic-side bone marrow increased alongwith bone resorption in the early stages of stroke.
Poster 445Urinary Tract Infection Is a Negative Predictorof Poststroke Disposition: Findings From theUTHSC Houston Stroke Registry.Nneka L. Ifejika-Jones, MD, MPH (UTHSC—Hous-ton, Houston, TX); Gerard E. Francisco, MD;James C. Grotta; Nusrat Harun, MSPH.
Disclosures: N. L. Ifejika-Jones, None.Objective: To determine whether urinary tract infection(UTI) is a predictor of disposition in patients with acutestroke.Design: Retrospective observational study of prospectivelycollected data from patients admitted to the UTHSC HoustonStroke Service.Setting: Single university-based hospital.Participants: All patients admitted between January 2004and October 2009 were included (n�3390). Stratificationoccurred for age�65 years, NIHSS, and stroke risk factors.Interventions: Low NIHSS (�8) is an established predic-tor of higher functional status at discharge. We assessed thehypothesis that absence of UTI predicts poststroke disposi-tion to a functional level similar to low NIHSS.Main Outcome Measures: By using multivariate logis-tic regression, the data were analyzed for differences in post-stroke disposition among patients without UTI. Odds ratio(OR) was calculated to determine the likelihood of dischargeto each level of care: home, inpatient rehabilitation (IR),skilled nursing facility (SNF), or subacute care (Sub).Results: Home versus other (IR, SNF, Sub): Of 3390 pa-tients, 1668 were discharged home, 1722 to another level ofcare. Patients without UTI are 2.5 times more likely to bedischarged home (P � �.0001, OR 2.571 [95% CI, 1.831-3.611]). Patients with NIHSS � 8 are 16.3 times more likelyto be discharged home. IR versus SNF: Of 1547 patients, 983patients were discharged to IR, 564 to SNF. Patients withoutUTI are 1.9 times more likely to be discharged to IR(P�.0001, OR 1.962 [95% CI, 1.391-2.768]). Patients withNIHSS �8 are 3.7 times more likely to be discharged to IR.SNF versus Sub: Of 739 patients, 564 were discharged toSNF, 175 to Sub. There were no significant differences indisposition among patients without UTI.Conclusions: Acute stroke patients without UTI are 2.5times more likely to be discharged home. If poststroke reha-bilitation is needed, then patients without UTI are 1.9 timesmore likely to be admitted to IR versus SNF. This study islimited by its retrospective nature and the undetermined role
of psychosocial factors related to discharge. Prospective stud-ies are warranted on the efficacy of early catheter discontin-uation after stroke and structured catheter care every shift bynursing.
SCIENTIFIC POSTER PRESENTATIONS
ADMINISTRATION
Poster 1A Survey: Where Did Patients Go After Strokein the Beijing Area?Dong Yan (In-tech Rehabilitation Hospital, Beijing,China); Hu W. Li.
Disclosures: D. Yan, None.Objective: To investigate where did the patients who suf-fered stroke transfer after the inpatient therapy in the biggeneral hospital in Beijing. It is part of the pilot of Three LevelPatients Transfer Network of Beijing Municipal HealthBureau.Design: Retrospective study.Setting: A standard questionnaire procedure.Participants: Followed-up 292 patients who had a strokeand underwent inpatient therapy at the Neurology Depart-ment of Chaoyang Hospital of Capital Medical Universityduring September to November 2009.Interventions: Select the patients after stroke at the Neu-rology Department of the general hospital, Chaoyang Hospi-tal. Record the inpatient days and the hospital where thepatients will transfer to. Telephone follow-up obtained in 1month.Main Outcome Measures: R: indicates the patientstransfer to a special rehabilitation hospital; T: indicates thepatients transfer to a Chinese traditional hospital; H: indi-cates the patients transfer directly to home; G: indicates thepatients transfer to other general hospital.Results: The average inpatient stay at Chaoyang was about12 days. After the inpatient therapy in Chaoyang hospital,transfers were R: 26 (8.9%); T: 109 (37.3%); G: 31 (10.6%);H: 126 (43.2%). 1 month follow-up were: 17 (5.8%); T: 96(32.9%); G: 12 (4.1%); H: 167 (57.2%).Conclusions: The patients after stroke in a big generalhospital were mainly transferred to sublevel Chinese tradi-tional hospital. Rehabilitation beds were heavily deficient inBeijing. The efficiency of the big general hospital should beimproved.
Poster 2A System Redesign Approach to ImprovingTimeliness of New Outpatient PM&R Consults:Veterans Affairs Observational Analysis andSystem Redesign.Ankur D. Mehta, DO, MBA (Loyola Medical CenterChicago, Chicago, IL); Sung Ahn, DO; Walter C.Damper, DO; Danilo Hipolito.
S9PM&R Vol. 2, Iss. 9S, 2010
