F-3-12-01
OUTCOME AND COST-EFFECTIVENESS OF ACUTE STROKE PATIENTS IN RURAL DISTRICT (THIRD REPORT)
Michitaka Fukuda (Hirosaki University, Hirosaki, Japan)
Izumi Kondo, Manabu Iwata, Masashi Souma, Hirofumi Metoki, Shigeo Matsumoto
[Background and purpose] Prior study have demonstrated the elder stroke patients (over 71 y.o.) might need long hospital stay and high medical cost, but the cost effectiveness remains unclear. We conducted 177 stroke patients to investigate this issue.
[Methods] The acute stroke patients admitted in Hokushu Hospital in rural district from 1994 to 1996 was divided 2 groups following by medical cost. Seventy one patients had been in the group of high medical cost (G.H) over the mean sum of medical cost (2,138,052 yen, about $17,800) and 1O1 patients in low medical cost (G.L).
[Results] 1) There was no difference between the age in G.H and G.L. 2) The patients in G.H had more severe motor impairment than those in G.L. 3) The numbers of complication of G.H were significantly higher than those of G.L. 4) The Barthel index score of G.H was significantly lower than those in G.L. 5) The recovery of impairment of lower extremity at discharge was significantly lower in G.H than those in G.L. 6) The changes of Barthel index score at discharge were significantly high in both groups. 7) There was no difference between both groups on outcome.
[Conclusion] 1) Our results suggest that the hospital in rural district needed long hospital stay and high medical cost not only for treatment during acute stage but also for rehabilitation during subacute and chronic stage.
F-3-12-02
USEFULNESS OF CBF SCINTIGRAPHY FOR ESTIMATION OF FUNCTIONAL OUTCOME IN PATIENTS WITH CVD.
Takashi Isaji (Ibaraki Prefectural University for Health Sciences, Ibaraki, Japan),
Akira Kogure, Fumihiko Tamamoto (Tokyo Metropolitan Otsuka Hospital, Tokyo, Japan),
Masahiro Mikami (Teikyo University, Tokyo, Japan)
The purpose of this clinical research is to find the relation between cerebral blood flow (CBF) and functional outcome.
One hundred and seven patients with cerebrovascular diseases (CVD), admitting for rehabilitation program, ranging in age from 28 to 83 yeas (mean±SD 61.3±11.2) were evaluated by CBF scintigraphy using 99mTcHMPAO, and calculated mean CBF(mCBF) and regional CBF(rCBF) by Patlak's plot method before rehabilitation. The patients were also evaluated on the basis of functional outcome and confirmed Barthel Index (BI) before and after rehabilitation.
BI after rehabilitation had a tendency to correlate not only with mCBF of whole brain(r=0.45, p<0.01) but also with mCBF of affected cerebral hemisphere(r=0.49, p<0.01) before rehabilitation.
Our data suggested that calculation of mCBF of whole brain before rehabilitation can estimate the functional outcome of the CVD patients, and mCBF of affected cerebral hemisphere especially attributes to the functional outcome.
