[Hemiplegia and return to domicile].
OBJECTIVE
We have studied the outcome after a stroke on being discharged from a department of physical medicine and rehabilitation in patients with hemiplegia, and the factors influencing the choice of the orientation.


METHODS
This prospective study was based on 93 patients. The mode of discharged was patient's domicile, institution, the number of death was also noted. The potentially influential factors studied were age, the side with hemiplegia, the aetiology of the hemiplegia, co-morbidity, the delay in starting rehabilitation, the neurological damage evaluated by the Orgogozo score, the initial functional damage evaluated by Functional Independence Measure (FIM) and by the functional score carried out within the framework PMSI(1) (computerised programme of medical care), the existence of aphasia, the existence of a depressive syndrome, presence of hemineglect, presence of superficial or profound sensory disorders, incontinence at the start of rehabilitation and at one month after the stroke, the existence of cognitive or psychiatric disorders. The tests used were the non-parametric test of Mann and Whitney, the chi(2) test and the correlation test. The threshold of significance used was 0.05.


RESULTS
Based on 93 patients (47 women and 46 men, average age 64.8) 81 have gone back to their previous domicile, 11 were oriented toward an institution. One patient died. The predictive factors or those linked to an absence of return to the previous domicile were the age, social situation, the delay in starting rehabilitation, presence of aphasia, the initial and final functional damage, the impossibility to walk, the presence of a depressive syndrome, urinary incontinence.


CONCLUSIONS
The authors stress the importance of familial environment and of functional independence in establishing a prognosis for return to the domicile.
Petrilli
S
S
Médecine physique et réadaptation, CHU Pontchaillou, rue Le Guilloux, 35033 cedex, Rennes, France.
Durufle
A
A
Nicolas
B
B
Pinel
J F
JF
Kerdoncuff
V
V
Gallien
P
P
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia; D003072:Cognition Disorders / Q000209:etiology; D005260:Female; D006304:Health Status; D006429:Hemiplegia / Q000209:etiology / Q000534:rehabilitation*; D006699:Home Care Services; D006801:Humans; D008297:Male; D001523:Mental Disorders; D008875:Middle Aged; D010351:Patient Discharge; D011379:Prognosis; D011446:Prospective Studies; D012047:Rehabilitation Centers; D012307:Risk Factors; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome