Socio-environmental predictive factors for discharge destination after inpatient rehabilitation in patients with stroke: a systematic review and meta-analysis

Purpose To identify which of the socio-environmental factors of patients with stroke are predictive for discharge to their home after inpatient rehabilitation. Because discharge planning is a key component of rehabilitation, it is important to recognize the predictive factors for a discharge home. Other systematic reviews demonstrated the value of functional outcome measures. This review adds to the current literature by assessing the predictive value of socio-environmental factors, which shape the context in which a person lives. Methods We performed a systematic search in seven databases. Two independent reviewers selected studies and assessed them for methodological quality. We extracted data to estimate pooled odds ratio for household situation, social support, ethnicity and socioeconomic status. Results Forty studies were included. Significant estimates were found for living with others (OR 2.60; 95%CI 1.84-3.68), having support at home (OR 11.48; 95%CI 6.52-20.21), being married (OR 2.05; 95%CI 1.80-2.33) and living at home before stroke (OR 31.01; 95%CI 7.38-130.18). Conclusion Living at home and benefiting from social support, including living with others, are important factors to consider during discharge planning after stroke. Further research should consider the impact of socioeconomic status.