回復期リハビリテーション病棟における認知症および認知症疑いのある運動器疾患患者の転帰先に関わる影響因子

Factors influencing outcomes in locomotor patients with dementia and suspected dementia in the recovery phase of a rehabilitation ward

要旨：本研究の目的は，回復期リハ病棟に入棟された認知症および認知症疑いのある患者（MMSEのスコアが23点以下）の転帰先への影響因子を明らかにすることである．基本属性，認知機能関連項目，FIM関連項目をカルテから抽出し，退院後の転帰先を「自宅群」「施設群」の2群に分けて解析したところ，「自宅群」130名，「施設群」58名となった．その2群間比較において統計学的に有意差が認められた項目を説明変数として，ステップワイズ多重ロジスティック回帰分析を実施した．その結果，移動手段と記憶障害が重要な因子として抽出され，作業療法士が対象者の認知症状を評価し，チームや家族と共に支援環境を整えていく必要性が示唆された．

　The purpose of this study is to clarify the factors that influence the outcome of patients with dementia and suspected dementia (MMSE score of 23 or less) admitted to the recovery phase rehabilitation ward. Basic attributes, cognitive function-related items, and FIM-related items were extracted from medical records and reports, and the outcomes after discharge were divided into two groups, “home group” and “facility group”, and analyzed. There were 130 items in the “home group” and 58 in the “facility group”, and stepwise multiple logistic regression analysis was performed using the items with statistically significant difference between the two groups as explanatory variables. As a result, mobility and memory impairment were extracted as important factors. As an occupational therapist, it is necessary to evaluate the cognitive symptoms of the subjects and prepare a support environment with the team and family.