Cho et al reported a risk score for post-stroke patients. This can help to determine if discharge location is appropriate for the patient. The patients are from the University of Tennessee at Chattanooga.
Patient selection: hospitalized adult after stroke
Parameters:
(1) sex
(2) age
(3) race
(4) stroke type
(5) comorbidity
(6) source of admission
(7) type of insurance
Parameter
Finding
Points
sex
male
0
female
1
age
18 to 64 years
0
65 to 74 years
1
>= 75 years
3
race
white
0
black
1
other
-1
stroke type
ischemic
0
meningeal hemorrhage
1
intracerebral hemorrhage
5
comorbidity
diabetes
1
hypercholesterolemia
-1
atrial fibrillation (AF)
2
chronic kidney disease
1
heart disease other than AMI and AF
1
TIA
1
acute heart attack
1
alcohol habit
2
drug habit
1
smoking
-1
family history (of what?)
-2
depression
2
other (exclude obesity, peripheral arterial disease, hypertension)
2
source of admission
nonhealthcare facility
0
clinic referral
0
transfer from hospital
1
skilled nursing facility
13
other
4
type of insurance
Medicare or Medicaid
0
private insurance
-3
other
-2
total score =
= SUM(points for all of the parameters)
Interpretation:
• A score < 9 is predicted to be discharged home.
• A score >= 9 is predicted to be discharged to a facility.
• The discharge decision was "validated" based on the readmission rate (the conjecture was that a patient properly discharged would be less likely to be readmitted).
• A patient with a high score may not be a good candidate to discharge home.
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