뇌졸중 환자의 입원 재활치료에 대한 장애평가

Abstract

Background : The Functional Independence Measure(FIM), a method to evaluate outcomes of stroke patientsundergoing comprehensive inpatient medical rehabilitation has been introduced in korea recently. The purpose of this study is to present the changes of disability following inpatient medical rehabilitation strategy and to evaluate the difference of FIM data between the year of 1997 and 1998. Methods : Our study group consists of 133 patients (85 men, 48 women) with disability caused by stroke from January 1997 to December 1998. 18 items, 7 level subscales of FIM (version 3.1) are used to scoring of the disability at the time of referral to inpatient medical rehabilitation program and at the end of these program by 2 weeks interval regularly. The average of length of stay(LOS : total number of days from referral for inpatient medical rehabilitation program to end of these program), onset day(mean interval between onset and the referral), FIM gain(difference between FIM score of referral day and discharge day), and FIM efficiency(the mean change of FIM score per day) are calculated. Results : Patients with cerebral hemorrhage and infarction each represented about 39.9% and 60.1% of the total. During two year span, (1) the onset day in 1997, 1998 is 25.3days, 16.9days respectively(p>0.05). (2) the FIM efficiency and the LOS are 0.85, 1.94 and 51.9days, 27.6 days respectively.(p<0.01) (3) FIM gain is 22.4, 19.7 respectively(p>0.05). Conclusion : These results suggest that during the two year period, there is a significant reduction in mean onset days and reduction in the mean length of stay(LOS) and the trends towards reduction on onset day, and as these results, the FIM efficiency is significantly increased in 1998 than that in 1997. Korean Journal of Stroke 1999;1(2): 220~224