Poor Functional Status of Stroke Patients after Hospital Discharge: Scope for Intervention?

In a follow-up study of stroke patients discharged from hospital after inpatient rehabilitation in a stroke unit, day-to-day functioning was assessed using the Barthel Index and the Frenchay Activities Index. Levels of dependency recorded at discharge tended to persist or worsen over the subsequent 7 to 12 months and very few patients returned to any domestic, leisure or outdoor activities once they were back in the community. Those in residential care were especially disadvantaged. Contact with health and social services was minimal. The findings suggest that there is considerable need for continuing support and intervention for stroke patients after in-hospital rehabilitation. The occupational therapist would seem potentially well-suited to this role.

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Stroke Unit Care for Acute Stroke Patients: An Observational Follow-up Study

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2007.05.003 ◽

2007 ◽

Vol 33 (2) ◽

pp. 225

Author(s):

Matthew Marion

Keyword(s):

Acute Stroke ◽

Stroke Unit ◽

Stroke Patients ◽

Follow Up Study ◽

Stroke Unit Care

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Faculty Opinions recommendation of Stroke-unit care for acute stroke patients: an observational follow-up study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1064745.517661 ◽

2007 ◽

Author(s):

Hans-Christoph Diener

Keyword(s):

Acute Stroke ◽

Stroke Unit ◽

Stroke Patients ◽

Follow Up Study ◽

Stroke Unit Care

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Who are the consistently high users of health and social services? A follow-up study two and a half years later of people aged 85+ at baseline

Health & Social Care in the Community ◽

10.1111/j.1365-2524.1993.tb00229.x ◽

2007 ◽

Vol 1 (5) ◽

pp. 277-287 ◽

Cited By ~ 7

Author(s):

Ann Bowling ◽

Morag Farquhar ◽

Emily Grundy

Keyword(s):

Social Services ◽

Health And Social Services ◽

Follow Up Study

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The follow-up of patients of sixty-five years of age and younger with acute ischemic stroke and transient ischemic attacks, and elevated D-dimer levels in plasma

Neurology International ◽

10.4081/ni.2009.e11 ◽

2009 ◽

Vol 1 (1) ◽

pp. 11

Author(s):

Magnus Vrethem ◽

Tomas Lindahl

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Stroke Unit ◽

Cardioembolic Stroke ◽

Transient Ischemic Attacks ◽

Stroke Patients ◽

Follow Up Study ◽

Cerebrovascular Events ◽

D Dimer

D-dimer levels in plasma, a degradation product of fibrin, have been shown to correlate with the severity of ischemic stroke. In order to investigate the outcome of patients with elevated D-dimer we have carried out a follow-up study of patients of 65 years of age and younger with acute ischemic stroke or transient ischemic attacks (TIA) admitted to our stroke unit from 1991 to 1992. Twenty-two of the 57 patients had elevated D-dimer levels in the plasma. High levels were associated with cardioembolic stroke. On follow-up after a mean of 12 years, 15 patients had died and six patients had suffered another stroke or TIA (three of whom were dead). Ten patients had suffered other cardiovascular events and seven of them were dead. We concluded that high levels of D-dimer in acute ischemic stroke patients on admission were associated with cardioembolic stroke and might have prognostic value for the development of further cardio- or cerebrovascular events. Advanced age was found to be an independent risk factor.

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Stroke-unit care for acute stroke patients: an observational follow-up study

The Lancet ◽

10.1016/s0140-6736(07)60152-4 ◽

2007 ◽

Vol 369 (9558) ◽

pp. 299-305 ◽

Cited By ~ 184

Author(s):

Livia Candelise ◽

Monica Gattinoni ◽

Anna Bersano ◽

Giuseppe Micieli ◽

Roberto Sterzi ◽

...

Keyword(s):

Acute Stroke ◽

Stroke Unit ◽

Stroke Patients ◽

Follow Up Study ◽

Stroke Unit Care

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Early prediction of falls after stroke: a 12-month follow-up of 490 patients in The Fall Study of Gothenburg (FallsGOT)

Clinical Rehabilitation ◽

10.1177/0269215518819701 ◽

2018 ◽

Vol 33 (4) ◽

pp. 773-783 ◽

Cited By ~ 6

Author(s):

Carina M Samuelsson ◽

Per-Olof Hansson ◽

Carina U Persson

Keyword(s):

Confidence Interval ◽

Postural Control ◽

Acute Phase ◽

Odds Ratio ◽

Stroke Unit ◽

Inpatient Rehabilitation ◽

Stroke Onset ◽

Multivariable Regression ◽

Walking Aid

Objective: To identify the incidence of falls and factors present shortly after stroke, which are associated with the occurrence of falls over the first 12 months after stroke onset, following discharge from inpatient rehabilitation. Design: Prospective follow-up study. Setting: Stroke unit and outpatient department. Subjects: A total of 490 individuals with acute stroke. Methods: Postural control was assessed using the Swedish modified version of the Postural Assessment Scale for Stroke Patients. Data on self-reported falls were collected using a standardized questionnaire at three months after discharge and six and 12 months after stroke onset. Associations between characteristics during the acute phase after a stroke and falls after six and 12 months were investigated using univariable and multivariable regression analyses. Main measures: The endpoint was a self-reported fall. Results: Within three months after discharge, 38 of 165 respondents (23%) had experienced at least one fall. Within six and 12 months after stroke onset, respectively, 108 of 376 (29%) and 140 of 348 (40%) of the respondents had experienced at least one fall. Poor postural control (odds ratio 3.92, 95% confidence interval 2.07–7.45, P < 0.0001) and using a walking aid (odds ratio 2.84, 95% confidence interval 1.71–4.72, P < 0.0001) were predictors of falls after discharge within 12 months after stroke onset. The same variables were independent predictors of falls within six months. Conclusion: Poor postural control and using a walking aid in the acute phase after a stroke are associated with falls after discharge from a stroke unit within 12 months after stroke onset.

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