J Neurol Res

Journal of Neurology Research, ISSN 1923-2845 print, 1923-2853 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Neurol Res and Elmer Press Inc

Journal website http://www.neurores.org

Original Article

Volume 1, Number 2, June 2011, pages 59-68

Re-Justification for Reducing the Length of Hospital Stay Based on Community-Based Appraisal of Functional Recovery of Cerebrovascular Disease Patient

**Table 1.** Patient Characteristics and Outcomes by Barthel Index Improvement Category
		Deterioration	No change	Improvement	P
RIND: reversible ischemic neurological deficit; SAH: subarachnoid hemorrhage; BI: Barthel index; SD: standard deviation; LVH: low-volume hospital; IVH: intermediate-volume hospital; HVH: high-volume hospital; LOS: length of hospital stay; TC: total charge; SD: standard deviation.
Overall		668	11440	7067
Age
	Mean age [SD]	73.7 [11.2]	66.5 [13.2]	69.5 [12.4]	< 0.001
	65 - 74 years	186 (27.8)	3652 (31.9)	2138 (30.3)	< 0.001
	75 - 84 years	246 (36.8)	2618 (22.9)	2065 (29.2)
	85 years and over	108 (16.2)	655 (5.7)	644 (9.1)
Gender
	Male	370 (55.4)	7561 (66.1)	4256 (60.2)	< 0.001
Transfer	not at home	329 (49.3)	957 (8.4)	1582 (22.4)	< 0.001
Ambulance	Use	184 (27.5)	1918 (16.8)	2658 (37.6)	< 0.001
Principal disease
	Transient ischemia	26 (3.9)	1252 (10.9)	563 (8)	< 0.001
	Lacunar infarction	129 (19.3)	1613 (14.1)	1237 (17.5)
	SAH	13 (1.9)	286 (2.5)	269 (3.8)
	Hemorrhage	47 (7)	619 (5.4)	706 (10)
	Nontraumatic subdural hematoma	36 (5.4)	580 (5.1)	418 (5.9)
	Infarction	370 (55.4)	4801 (42)	3542 (50.1)
	RIND	47 (7)	2289 (20)	332 (4.7)
BI at admission
	Dependent	189 (28.3)	982 (8.6)	4174 (59.1)	< 0.001
	Assisted independence	108 (16.2)	285 (2.5)	1789 (25.3)
	Independence with minimal assistance	371 (55.5)	10173 (88.9)	1104 (15.6)
Charlson comorbidity index				< 0.001
	1	188 (28.1)	3043 (26.6)	1898 (26.9)	< 0.001
	2	106 (15.9)	1249 (10.9)	1006 (14.2)
	3	40 (6)	363 (3.2)	349 (4.9)
	4 or more	19 (2.8)	134 (1.2)	125 (1.8)
Preexisting cognitive impairment	2 (0.3)	0 (0)	5 (0.1)	< 0.001
Preexisting cerebrovascular disease	111 (16.6)	1835 (16)	1041 (14.7)	0.044
Atrial fibrillation or flutter	52 (7.8)	522 (4.6)	477 (6.7)	< 0.001
Procedure-related complication	8 (1.2)	112 (1)	60 (0.8)	0.524
Cognitive impairment after admission	3 (0.4)	31 (0.3)	22 (0.3)	0.660
Deep vein thrombosis and pulmonary embolism	1 (0.1)	20 (0.2)	15 (0.2)	0.827
Procedure
Surgical procedure
	Present	135 (20.2)	1905 (16.7)	864 (12.2)	< 0.001
Ventilation
	Administered	10 (1.5)	126 (1.1)	60 (0.8)	0.117
	Mean days administered [SD]	2.8 [3.6]	3.9 [5.2]	3.8 [7.3]	0.847
Rehabilitation
	Administered	398 (59.6)	3392 (29.7)	3769 (53.3)	< 0.001
	Mean days administered [SD]	16.0 [17.6]	10.1 [12.9]	12.9 [13.9]	< 0.001
Hospital
Patient volume
	LVH	212 (31.7)	4233 (37.0)	2087 (29.5)	< 0.001
	IVH	205 (30.7)	3998 (34.9)	2279 (32.2)
	HVH	251 (37.6)	3209 (28.1)	2701 (38.2)
Teaching status
	Academic	141 (21.1)	3247 (28.4)	1196 (16.9)	< 0.001
Fiscal year
	2004	90 (3.8)	1505 (63.4)	779 (32.8)	< 0.001
	2005	143 (3.5)	2524 (60.9)	1476 (35.6)
	2006	188 (3.2)	3585 (60.5)	2156 (36.4)
	2007	128 (3.7)	1926 (55.4)	1425 (41.0)
	2008	119 (3.7)	1900 (58.5)	1231 (37.9)
Resource use
Mean LOS, days [SD]	27.6 [25.1]	13.9 [14.2]	19.4 [16.7]	< 0.001
Mean TC, $ [SD]	10362 [8779]	5948 [6199]	7706 [6867]	< 0.001

Table 1. Patient Characteristics and Outcomes by Barthel Index Improvement Category

Deterioration

No change

Improvement

RIND: reversible ischemic neurological deficit; SAH: subarachnoid hemorrhage; BI: Barthel index; SD: standard deviation; LVH: low-volume hospital; IVH: intermediate-volume hospital; HVH: high-volume hospital; LOS: length of hospital stay; TC: total charge; SD: standard deviation.

Overall

668

11440

7067

Age

Mean age [SD]

73.7 [11.2]

66.5 [13.2]

69.5 [12.4]

< 0.001

65 - 74 years

186 (27.8)

3652 (31.9)

2138 (30.3)

< 0.001

75 - 84 years

246 (36.8)

2618 (22.9)

2065 (29.2)

85 years and over

108 (16.2)

655 (5.7)

644 (9.1)

Gender

Male

370 (55.4)

7561 (66.1)

4256 (60.2)

< 0.001

Transfer

not at home

329 (49.3)

957 (8.4)

1582 (22.4)

< 0.001

Ambulance

Use

184 (27.5)

1918 (16.8)

2658 (37.6)

< 0.001

Principal disease

Transient ischemia

26 (3.9)

1252 (10.9)

563 (8)

< 0.001

Lacunar infarction

129 (19.3)

1613 (14.1)

1237 (17.5)

SAH

13 (1.9)

286 (2.5)

269 (3.8)

Hemorrhage

47 (7)

619 (5.4)

706 (10)

Nontraumatic subdural hematoma

36 (5.4)

580 (5.1)

418 (5.9)

Infarction

370 (55.4)

4801 (42)

3542 (50.1)

RIND

47 (7)

2289 (20)

332 (4.7)

BI at admission

Dependent

189 (28.3)

982 (8.6)

4174 (59.1)

< 0.001

Assisted independence

108 (16.2)

285 (2.5)

1789 (25.3)

Independence with minimal assistance

371 (55.5)

10173 (88.9)

1104 (15.6)

Charlson comorbidity index

< 0.001

188 (28.1)

3043 (26.6)

1898 (26.9)

< 0.001

106 (15.9)

1249 (10.9)

1006 (14.2)

40 (6)

363 (3.2)

349 (4.9)

4 or more

19 (2.8)

134 (1.2)

125 (1.8)

Preexisting cognitive impairment

2 (0.3)

0 (0)

5 (0.1)

< 0.001

Preexisting cerebrovascular disease

111 (16.6)

1835 (16)

1041 (14.7)

0.044

Atrial fibrillation or flutter

52 (7.8)

522 (4.6)

477 (6.7)

< 0.001

Procedure-related complication

8 (1.2)

112 (1)

60 (0.8)

0.524

Cognitive impairment after admission

3 (0.4)

31 (0.3)

22 (0.3)

0.660

Deep vein thrombosis and pulmonary embolism

1 (0.1)

20 (0.2)

15 (0.2)

0.827

Procedure

Surgical procedure

Present

135 (20.2)

1905 (16.7)

864 (12.2)

< 0.001

Ventilation

Administered

10 (1.5)

126 (1.1)

60 (0.8)

0.117

Mean days administered [SD]

2.8 [3.6]

3.9 [5.2]

3.8 [7.3]

0.847

Rehabilitation

Administered

398 (59.6)

3392 (29.7)

3769 (53.3)

< 0.001

Mean days administered [SD]

16.0 [17.6]

10.1 [12.9]

12.9 [13.9]

< 0.001

Hospital

Patient volume

LVH

212 (31.7)

4233 (37.0)

2087 (29.5)

< 0.001

IVH

205 (30.7)

3998 (34.9)

2279 (32.2)

HVH

251 (37.6)

3209 (28.1)

2701 (38.2)

Teaching status

Academic

141 (21.1)

3247 (28.4)

1196 (16.9)

< 0.001

Fiscal year

2004

90 (3.8)

1505 (63.4)

779 (32.8)

< 0.001

2005

143 (3.5)

2524 (60.9)

1476 (35.6)

2006

188 (3.2)

3585 (60.5)

2156 (36.4)

2007

128 (3.7)

1926 (55.4)

1425 (41.0)

2008

119 (3.7)

1900 (58.5)

1231 (37.9)

Resource use

Mean LOS, days [SD]

27.6 [25.1]

13.9 [14.2]

19.4 [16.7]

< 0.001

Mean TC, $ [SD]

10362 [8779]

5948 [6199]

7706 [6867]

< 0.001

**Table 2.** Factors Associated With Improvement of Barthel Index
Independent variables	Model 1	Model 2	Model 3
CI: confidence interval; RIND: reversible ischemic neurological deficit; SAH: subarachnoid hemorrhage; BI: Barthel index; LOS: length of stay; LVH: low-volume hospital; IVH: intermediate-volume hospital; HVH: high-volume hospital; a: LOS15 - 64 years; b: LOS65 - 74 years; c: LOS75 - 84 years; d: LOS85 – years; e: LOSTIA; f: LOSlacunar; g: LOSSAH; h: LOShemorrhage; I: LOSsubdural hematoma; j: LOSinfarction; k: LOS*RIND.
Intercept	51.6	[46.7 - 56.4]	49.8	[44.8 - 54.7]	50.5	[44.5 - 56.5]
Age (for 15 - 64 years)
65 - 74 years	-2.0	[-3.2 - -0.8]	-0.4	[-2.3 - 1.4]	-2.0	[-3.2 - -0.8]
75 - 84 years	-4.8	[-6.0 - -3.5]	-2.1	[-4.0 - -0.1]	-4.8	[-6.0 - -3.5]
85 years and over	-13.3	[-15.2 - -11.4]	-10.6	[-13.4 - -7.8]	-13.3	[-15.1 - -11.4]
Male	0.4	[-0.6 - 1.4]	0.3	[-0.7 - 1.3]	0.3	[-0.7 - 1.3]
Transfer not at home	-16.2	[-17.5 - -15.0]	-16.1	[-17.4 - -14.9]	-16.2	[-17.5 - -15.0]
Ambulance	4.0	[2.9 - 5.1]	4.0	[2.9 - 5.1]	4.0	[2.8 - 5.1]
Principal Diagnosis (for TIA)
Lacunar	-1.0	[-4.7 - 2.7]	-1.0	[-4.8 - 2.7]	-0.6	[-5.9 - 4.7]
SAH	16.6	[11.6 - 21.6]	16.4	[11.3 - 21.4]	20.8	[13.3 - 28.4]
Hemorrhage	3.0	[-0.9 - 6.9]	2.9	[-1 - 6.8]	0.3	[-5.3 - 6.0]
Subdural hematoma	-2.2	[-7.2 - 2.8]	-2.1	[-7.1 - 3.0]	3.8	[-3.4 - 11.0]
Infarction	-0.7	[-4.3 - 2.9]	-0.7	[-4.4 - 2.9]	0.4	[-4.7 - 5.5]
RIND	0.2	[-4.0 - 4.4]	0.2	[-4.0 - 4.4]	3.2	[-3.1 - 9.5]
BI at admission (for dependent)
Assisted independence	-24.7	[-26.2 - -23.2]	-24.7	[-26.2 - -23.2]	-24.7	[-26.2 - -23.2]
Independence with minimal assistance	-46.3	[-47.6 - -45.1]	-46.2	[-47.4 - -45]	-46.3	[-47.5 - -45.1]
Charlson comorbidity index (for zero)
1	-1.0	[-2.2 - 0.3]	-0.9	[-2.1 - 0.3]	-1.0	[-2.2 - 0.3]
2	-1.4	[-2.8 - 0.0]	-1.4	[-2.9 - 0.0]	-1.4	[-2.9 - 0.0]
3	-1.3	[-3.5 - 0.8]	-1.3	[-3.4 - 0.9]	-1.4	[-3.6 - 0.8]
4 or more	-3.2	[-6.6 - 0.1]	-3.1	[-6.5 - 0.3]	-3.3	[-6.6 - 0.1]
Cerebral vascular accident	-0.2	[-1.7 - 1.4]	-0.1	[-1.6 - 1.4]	-0.1	[-1.7 - 1.4]
Dementia	-10.3	[-26.8 - 6.3]	-10.3	[-26.9 - 6.2]	-10.2	[-26.7 - 6.4]
Atrial fibrillation or flutter	-1.2	[-3.1 - 0.6]	-1.2	[-3.0 - 0.7]	-1.2	[-3.1 - 0.7]
Procedure-related complication	-2.7	[-8.6 - 3.3]	-2.3	[-8.3 - 3.6]	-3.0	[-9.0 - 3.0]
Cognitive impairment after admission	-1.3	[-9.2 - 6.5]	-0.9	[-8.7 - 7.0]	-1.0	[-8.9 - 6.8]
Deep vein thrombosis	-0.3	[-9.4 - 8.8]	-0.2	[-9.4 - 8.9]	-0.7	[-9.8 - 8.4]
Procedure (reference; Medical)	-1.8	[-3.8 - 0.2]	-2.0	[-4 - 0.0]	-2.2	[-4.2 - -0.1]
Ventilation	-4.0	[-8.3 - 0.3]	-4.5	[-8.8 - -0.2]	-3.6	[-8.0 - 0.7]
Patient volume (reference; LVH)
IVH	-1.4	[-3.7 - 0.9]	-1.4	[-3.8 - 0.9]	-1.4	[-3.7 - 0.9]
HVH	0.1	[-2.6 - 2.9]	0.1	[-2.8 - 2.9]	0.2	[-2.7 - 3.0]
Hospital (reference; Community)
Academic	-1.2	[-3.6 - 1.2]	-1.2	[-3.7 - 1.2]	-1.2	[-3.6 - 1.2]
Fiscal year (for 2004)
2005	1.5	[-0.7 - 3.7]	1.6	[-0.7 - 3.8]	1.5	[-0.7 - 3.7]
2006	1.6	[-0.7 - 3.8]	1.7	[-0.5 - 4.0]	1.7	[-0.5 - 4.0]
2007	2.4	[0.1 - 4.7]	2.5	[0.2 - 4.9]	2.6	[0.2 - 4.9]
2008	3.0	[0.6 - 5.3]	3.1	[0.8 - 5.5]	3.2	[0.8 - 5.5]
LOS, one more day	-0.174	[-0.230 - -0.118]	^a -0.104	[-0.172 - -0.037]	^e -0.114	[-0.357 - 0.129]
			^b -0.174	[-0.243 - -0.106]	^f -0.152	[-0.230 - -0.074]
			^c -0.224	[-0.293 - -0.156]	^g -0.250	[-0.371 - -0.130]
			^d -0.221	[-0.306 - -0.136]	^h -0.032	[-0.124 - 0.061]
					ⁱ -0.417	[-0.610 - -0.225]
					^j -0.181	[-0.240 - -0.121]
					^k -0.252	[-0.386 - -0.118]
Initiation of rehabilitation, one day delayed	0.075	[0.002 - 0.147]	0.083	[-0.001 - 0.167]	0.079	[-0.005 - 0.163]
Rehabilitation, one more day	0.075	[-0.009 - 0.158]	0.075	[0.002 - 0.149]	0.070	[-0.003 - 0.143]
Akaike information criteria	67331.7	67207.0	67205.5

Table 2. Factors Associated With Improvement of Barthel Index

Independent variables

Model 1

Model 2

Model 3

Estimation 95% CI

CI: confidence interval; RIND: reversible ischemic neurological deficit; SAH: subarachnoid hemorrhage; BI: Barthel index; LOS: length of stay; LVH: low-volume hospital; IVH: intermediate-volume hospital; HVH: high-volume hospital; a: LOS*15 - 64 years; b: LOS*65 - 74 years; c: LOS*75 - 84 years; d: LOS*85 – years; e: LOS*TIA; f: LOS*lacunar; g: LOS*SAH; h: LOS*hemorrhage; I: LOS*subdural hematoma; j: LOS*infarction; k: LOS*RIND.

Intercept

51.6

[46.7 - 56.4]

49.8

[44.8 - 54.7]

50.5

[44.5 - 56.5]

Age (for 15 - 64 years)

65 - 74 years

-2.0

[-3.2 - -0.8]

-0.4

[-2.3 - 1.4]

-2.0

[-3.2 - -0.8]

75 - 84 years

-4.8

[-6.0 - -3.5]

-2.1

[-4.0 - -0.1]

-4.8

[-6.0 - -3.5]

85 years and over

-13.3

[-15.2 - -11.4]

-10.6

[-13.4 - -7.8]

-13.3

[-15.1 - -11.4]

Male

0.4

[-0.6 - 1.4]

0.3

[-0.7 - 1.3]

0.3

[-0.7 - 1.3]

Transfer not at home

-16.2

[-17.5 - -15.0]

-16.1

[-17.4 - -14.9]

-16.2

[-17.5 - -15.0]

Ambulance

4.0

[2.9 - 5.1]

4.0

[2.9 - 5.1]

4.0

[2.8 - 5.1]

Principal Diagnosis (for TIA)

Lacunar

-1.0

[-4.7 - 2.7]

-1.0

[-4.8 - 2.7]

-0.6

[-5.9 - 4.7]

SAH

16.6

[11.6 - 21.6]

16.4

[11.3 - 21.4]

20.8

[13.3 - 28.4]

Hemorrhage

3.0

[-0.9 - 6.9]

2.9

[-1 - 6.8]

0.3

[-5.3 - 6.0]

Subdural hematoma

-2.2

[-7.2 - 2.8]

-2.1

[-7.1 - 3.0]

3.8

[-3.4 - 11.0]

Infarction

-0.7

[-4.3 - 2.9]

-0.7

[-4.4 - 2.9]

0.4

[-4.7 - 5.5]

RIND

0.2

[-4.0 - 4.4]

0.2

[-4.0 - 4.4]

3.2

[-3.1 - 9.5]

BI at admission (for dependent)

Assisted independence

-24.7

[-26.2 - -23.2]

-24.7

[-26.2 - -23.2]

-24.7

[-26.2 - -23.2]

Independence with minimal assistance

-46.3

[-47.6 - -45.1]

-46.2

[-47.4 - -45]

-46.3

[-47.5 - -45.1]

Charlson comorbidity index (for zero)

-1.0

[-2.2 - 0.3]

-0.9

[-2.1 - 0.3]

-1.0

[-2.2 - 0.3]

-1.4

[-2.8 - 0.0]

-1.4

[-2.9 - 0.0]

-1.4

[-2.9 - 0.0]

-1.3

[-3.5 - 0.8]

-1.3

[-3.4 - 0.9]

-1.4

[-3.6 - 0.8]

4 or more

-3.2

[-6.6 - 0.1]

-3.1

[-6.5 - 0.3]

-3.3

[-6.6 - 0.1]

Cerebral vascular accident

-0.2

[-1.7 - 1.4]

-0.1

[-1.6 - 1.4]

-0.1

[-1.7 - 1.4]

Dementia

-10.3

[-26.8 - 6.3]

-10.3

[-26.9 - 6.2]

-10.2

[-26.7 - 6.4]

Atrial fibrillation or flutter

-1.2

[-3.1 - 0.6]

-1.2

[-3.0 - 0.7]

-1.2

[-3.1 - 0.7]

Procedure-related complication

-2.7

[-8.6 - 3.3]

-2.3

[-8.3 - 3.6]

-3.0

[-9.0 - 3.0]

Cognitive impairment after admission

-1.3

[-9.2 - 6.5]

-0.9

[-8.7 - 7.0]

-1.0

[-8.9 - 6.8]

Deep vein thrombosis

-0.3

[-9.4 - 8.8]

-0.2

[-9.4 - 8.9]

-0.7

[-9.8 - 8.4]

Procedure (reference; Medical)

-1.8

[-3.8 - 0.2]

-2.0

[-4 - 0.0]

-2.2

[-4.2 - -0.1]

Ventilation

-4.0

[-8.3 - 0.3]

-4.5

[-8.8 - -0.2]

-3.6

[-8.0 - 0.7]

Patient volume (reference; LVH)

IVH

-1.4

[-3.7 - 0.9]

-1.4

[-3.8 - 0.9]

-1.4

[-3.7 - 0.9]

HVH

0.1

[-2.6 - 2.9]

0.1

[-2.8 - 2.9]

0.2

[-2.7 - 3.0]

Hospital (reference; Community)

Academic

-1.2

[-3.6 - 1.2]

-1.2

[-3.7 - 1.2]

-1.2

[-3.6 - 1.2]

Fiscal year (for 2004)

2005

1.5

[-0.7 - 3.7]

1.6

[-0.7 - 3.8]

1.5

[-0.7 - 3.7]

2006

1.6

[-0.7 - 3.8]

1.7

[-0.5 - 4.0]

1.7

[-0.5 - 4.0]

2007

2.4

[0.1 - 4.7]

2.5

[0.2 - 4.9]

2.6

[0.2 - 4.9]

2008

3.0

[0.6 - 5.3]

3.1

[0.8 - 5.5]

3.2

[0.8 - 5.5]

LOS, one more day

-0.174

[-0.230 - -0.118]

^a -0.104

[-0.172 - -0.037]

^e -0.114

[-0.357 - 0.129]

^b -0.174

[-0.243 - -0.106]

^f -0.152

[-0.230 - -0.074]

^c -0.224

[-0.293 - -0.156]

^g -0.250

[-0.371 - -0.130]

^d -0.221

[-0.306 - -0.136]

^h -0.032

[-0.124 - 0.061]

ⁱ -0.417

[-0.610 - -0.225]

^j -0.181

[-0.240 - -0.121]

^k -0.252

[-0.386 - -0.118]

Initiation of rehabilitation, one day delayed

0.075

[0.002 - 0.147]

0.083

[-0.001 - 0.167]

0.079

[-0.005 - 0.163]

Rehabilitation, one more day

0.075

[-0.009 - 0.158]

0.075

[0.002 - 0.149]

0.070

[-0.003 - 0.143]

Akaike information criteria

67331.7

67207.0

67205.5

**Table 3.** Factors Associated With Deterioration of Barthel Index
Independent variables	Odd ratio	95% CI
CI: confidence interval; RIND: reversible ischemic neurological deficit; SAH: subarachnoid hemorrhage; BI: Barthel index; LOS: length of stay; LVH: low-volume hospital; IVH: intermediate-volume hospital; HVH: high-volume hospital.
Age (for 15 – 64 years)
65 – 74 years	1.418	[1.043 - 1.928]
75 – 84 years	1.886	[1.394 - 2.552]
85 years and over	2.540	[1.711 - 3.771]
Male	0.909	[0.726 - 1.138]
Transfer not at home	6.402	[4.993 - 8.207]
Ambulance	1.063	[0.831 - 1.361]
Principal Diagnosis (for TIA)
Lacunar	1.576	[0.552 - 4.497]
SAH	0.813	[0.220 - 2.999]
Hemorrhage	0.981	[0.325 - 2.963]
Subdural hematoma	1.860	[0.542 - 6.380]
Infarction	1.627	[0.578 - 4.581]
RIND	1.071	[0.336 - 3.417]
BI at admission (for dependent)
Assisted independence	3.321	[2.385 - 4.624]
Independence with minimal assistance	4.638	[3.497 - 6.150]
Charlson comorbidity index (for zero)
1	1.003	[0.759 - 1.325]
2	1.083	[0.793 - 1.481]
3	1.228	[0.782 - 1.930]
4 or more	1.896	[1.034 - 3.476]
Cerebral vascular accident	1.238	[0.896 - 1.712]
Dementia	4.624	[0.242 - 88.343]
Atrial fibrillation or flutter	1.047	[0.711 - 1.544]
Procedure-related complication	2.308	[0.881 - 6.047]
Cognitive impairment after admission	1.355	[0.265 - 6.933]
Deep vein thrombosis	0.329	[0.033 - 3.250]
Procedure (reference; Medical)	1.294	[0.878 - 1.907]
Ventilation	1.146	[0.502 - 2.619]
Patient volume (reference; LVH)
IVH	1.275	[0.967 - 1.679]
HVH	1.357	[1.036 - 1.777]
Hospital (reference; Community)
Academic	0.849	[0.632 - 1.141]
Fiscal year (for 2004)
2005	1.396	[0.838 - 2.325]
2006	1.101	[0.660 - 1.838]
2007	1.289	[0.765 - 2.172]
2008	1.168	[0.690 - 1.979]
LOS, one more day	1.010	[1.001 - 1.019]
Initiation of rehabilitation, one day delayed	1.016	[1.002 - 1.031]
Rehabilitation, one more day	1.004	[0.991 - 1.016]
Cox & Snell R², Nagelkerke R²	0.065, 0.191

Table 3. Factors Associated With Deterioration of Barthel Index

Independent variables

Odd ratio

95% CI

Age (for 15 – 64 years)

65 – 74 years

1.418

[1.043 - 1.928]

75 – 84 years

1.886

[1.394 - 2.552]

85 years and over

2.540

[1.711 - 3.771]

Male

0.909

[0.726 - 1.138]

Transfer not at home

6.402

[4.993 - 8.207]

Ambulance

1.063

[0.831 - 1.361]

Principal Diagnosis (for TIA)

Lacunar

1.576

[0.552 - 4.497]

SAH

0.813

[0.220 - 2.999]

Hemorrhage

0.981

[0.325 - 2.963]

Subdural hematoma

1.860

[0.542 - 6.380]

Infarction

1.627

[0.578 - 4.581]

RIND

1.071

[0.336 - 3.417]

BI at admission (for dependent)

Assisted independence

3.321

[2.385 - 4.624]

Independence with minimal assistance

4.638

[3.497 - 6.150]

Charlson comorbidity index (for zero)

1.003

[0.759 - 1.325]

1.083

[0.793 - 1.481]

1.228

[0.782 - 1.930]

4 or more

1.896

[1.034 - 3.476]

Cerebral vascular accident

1.238

[0.896 - 1.712]

Dementia

4.624

[0.242 - 88.343]

Atrial fibrillation or flutter

1.047

[0.711 - 1.544]

Procedure-related complication

2.308

[0.881 - 6.047]

Cognitive impairment after admission

1.355

[0.265 - 6.933]

Deep vein thrombosis

0.329

[0.033 - 3.250]

Procedure (reference; Medical)

1.294

[0.878 - 1.907]

Ventilation

1.146

[0.502 - 2.619]

Patient volume (reference; LVH)

IVH

1.275

[0.967 - 1.679]

HVH

1.357

[1.036 - 1.777]

Hospital (reference; Community)

Academic

0.849

[0.632 - 1.141]

Fiscal year (for 2004)

2005

1.396

[0.838 - 2.325]

2006

1.101

[0.660 - 1.838]

2007

1.289

[0.765 - 2.172]

2008

1.168

[0.690 - 1.979]

LOS, one more day

1.010

[1.001 - 1.019]

Initiation of rehabilitation, one day delayed

1.016

[1.002 - 1.031]

Rehabilitation, one more day

1.004

[0.991 - 1.016]

Cox & Snell R², Nagelkerke R²

0.065, 0.191