title: Role of aphasia in discharge location after stroke.
abstract: OBJECTIVE
  To evaluate language deficits after acute stroke and their association with post-acute care at a setting other than home. We hypothesized that deficits in language comprehension would be associated with discharge to a setting other than home after adjustment for physical/occupational therapy (PT/OT) needs.
  
  
  METHODS
  Secondary analysis of prospectively collected data. Discharge location, demographic characteristics (age, sex, race), and the presence of PT/OT recommendations were abstracted from the medical record.
  
  
  METHODS
  Acute stroke unit at a tertiary medical center.
  
  
  METHODS
  Left hemispheric stroke patients (N=152) within 24 hours of event.
  
  
  METHODS
  The following tasks were administered: (a-b) oral and written naming of pictured objects, (c) oral naming with tactile input (tactile naming), (d-f) oral reading, oral spelling, and repetition of words and pseudowords, (g) written spelling to dictation, (h) spoken word-picture verification (ie, auditory comprehension), and (i) written word-picture verification (ie, written word comprehension).
  
  
  METHODS
  Discharge to a setting other than home.
  
  
  RESULTS
  Of 152 cases, 88 were discharged home and 64 to another setting. Among stroke subjects discharged to a setting other than home, 63.6% had auditory comprehension deficits compared with 42.9% of those discharged home (P=.03). Deficits in auditory and reading comprehension and oral spelling to dictation were significantly associated with increased odds of discharge to a setting other than home after adjustment for age and PT/OT recommendations.
  
  
  CONCLUSIONS
  Cases with deficits in auditory comprehension, reading comprehension, and oral spelling to dictation had increased odds of being discharged to settings other than home. Early evaluation of these language deficits and prompt treatment may allow patients who would otherwise be discharged to an institution to go home. Further research is needed to design and evaluate individualized treatment protocols and their effect on discharge recommendations.
authors.affiliation: Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD, USA. mgonzal5@jhmi.edu
authors.forename: Marlís
authors.initials: M
authors.lastname: González-Fernández
authors.forename: Asare B
authors.initials: AB
authors.lastname: Christian
authors.forename: Cameron
authors.initials: C
authors.lastname: Davis
authors.forename: Argye E
authors.initials: AE
authors.lastname: Hillis
mesh_terms: D001037:Aphasia / Q000209:etiology* / Q000534:rehabilitation; D001308:Auditory Perceptual Disorders / Q000209:etiology; D032882:Comprehension; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009788:Occupational Therapy; D010351:Patient Discharge / Q000706:statistics & numerical data*; D026741:Physical Therapy Modalities; D011932:Reading; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation