Acute stroke unit care combined with early supported discharge. Long-term effects on quality of life. A randomized controlled trial

Fjærtoft, Hild; Indredavik, Bent; Johnsen, Roar; Lydersen, Stian

doi:10.1191/0269215504cr773oa

Cited by 89 publications

(71 citation statements)

References 21 publications

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“…Details regarding the study design, the method of randomization, the inclusion criteria, and the intervention have been reported previously. [5][6][7][8] The Regional Committee for Medical Research approved the study protocol.…”

Section: Methodsmentioning

confidence: 99%

“…The benefits attributed to the ESD group consisted of improved functional ability, 4,8 healthrelated quality of life, 6 resource use, and reduced costs 7 during the first year after a stroke, as presented. We have also previously explored the association between stroke severity and benefit of ESD versus OSUS.…”

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confidence: 99%

“…Randomized controlled trials of early supported discharge (ESD) and further rehabilitation at home have documented great benefits, mostly in reduced length of hospital stay (8 days). 3,4 Some trials also have documented improved functional outcome, improved quality of life, and reduced costs [3][4][5][6][7][8] up to 1 year after stroke. The current recommendation from the ESD trialists group, based on a meta-analysis on 12 randomized controlled trials, 3,4,9 is an ESD service consisting of a coordinating multidisciplinary team, because this is the most effective form of organization in follow-up and rehabilitation.…”

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confidence: 99%

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Stroke Unit Care Combined With Early Supported Discharge Improves 5-Year Outcome

Fjærtoft

Rohweder

Indredavik

2011

Stroke

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Background and Purpose-Early supported discharge (ESD) seems to be a promising alternative to conventional follow-up care after acute stroke. We have previously shown that stroke unit care combined with ESD has beneficial effects on functional outcome and the use of resources for up to 1 year. The aim of this trial was to evaluate outcome after 5 years. Methods-We performed a randomized controlled trial with 320 acute stroke patients allocated to ordinary stroke unit care (160 patients) or stroke unit care with ESD (160 patients). The ESD service consisted of a mobile team that co-coordinated hospital discharge and further rehabilitation during 1 month of follow-up in cooperation with the primary health care. Mortality, residence, and functional outcome including modified Rankin scale were registered after 5 years. All assessments were blinded. Results-There was no difference between the groups with modified Rankin scale score Յ2 (Pϭ0.213), but there was a trend toward greater improvement in modified Rankin scale score in the ESD group from onset of stroke (38% versus 30%; Pϭ0.106). More patients were dead or institutionalized in the ordinary stroke unit care group (Pϭ0.032); 158 patients were alive, 84 were in ESD, and 74 were in ordinary stroke unit care. Of the 158 patients alive, a greater proportion were living at home in ESD (86%/70%; Pϭ0.019). Conclusions-Stroke unit care combined with ESD seems to reduce death and institutional care and to improve patients' chances of living at home 5 years after stroke compared to traditional stroke care. There is a trend toward improved functional outcome in the ESD group. (Stroke. 2011;42:1707-1711.)

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Stroke Unit Care Combined With Early Supported Discharge Improves 5-Year Outcome

Fjærtoft

Rohweder

Indredavik

2011

Stroke

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“…Los estudios de costo beneficio han mostrado una reducción de los gastos que ocasiona la ECV, en especial los días cama y las complicaciones [16][17][18][19] . En nuestra serie, los costos no son mayores a pacientes similares hospitalizados en neurología o en los intermedios de medicina o neuroquirúrgico del hospital.…”

Section: Tabla 1 Características De Los Pacientes Ingresados a Utac unclassified

Evaluación de una unidad de tratamiento del ataque cerebral en un hospital universitario

et al. 2006

Rev. méd. Chile

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“…Today's health care environment has high expectations of the caregiver, particularly when they are a family member. For many survivors of cerebro-vascular accidents, it can happen that the only caregiver available is a fragile spouse or elderly family member who is overwhelmed by health problems of their own (Fjaertoft, Indredavik, Johnsen, & Lydersen, 2004). Therefore, caring for a person with a cerebro-vascular accident can have a detrimental effect on the caregiver's health, possibly leading to the health service having to respond to their needs as well (Low, Roderick, & Payne, 2004;Ritcher & Peu, 2004).…”

Section: Introductionmentioning

confidence: 99%

Assessment of experiences of survivors of cerebro-vascular accidents and their caregivers functioning at home in the Oshana region of Namibia

Kuugongelwa

Small²

2015

IJANS

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<p>In the wake of a cerebro-vascular accident, survivor and caregiver are often apprehensive about being on their own at home; this is particularly so for those living in low socioeconomic circumstances in the rural areas of Namibia. The situation is aggravated by the fact that there is no structured system of home visits by health workers that could assist caregivers in their daily tasks. Phenomenological interviews were therefore conducted to explore how these caregivers cope with providing home care to the survivors of such accidents. The findings that emerged were categorised into four themes, namely, survivors were unable to provide self-care and were dependent on others for help, the altered role function and performance of survivors, negative emotions because of altered self-esteem, and disrupted social interaction. These experiences together illustrate that some survivors are unable to take care of themselves at all and depend completely on their caregivers for help.</p>

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Acute stroke unit care combined with early supported discharge. Long-term effects on quality of life. A randomized controlled trial

Abstract: It seems that stroke unit treatment combined with early supported discharge in addition to reducing the length of hospital stay can improve long-term QoL. However, similar trials are necessary to confirm the benefit of this type of service.

Cited by 89 publications

References 21 publications

Stroke Unit Care Combined With Early Supported Discharge Improves 5-Year Outcome

Stroke Unit Care Combined With Early Supported Discharge Improves 5-Year Outcome

Evaluación de una unidad de tratamiento del ataque cerebral en un hospital universitario

Assessment of experiences of survivors of cerebro-vascular accidents and their caregivers functioning at home in the Oshana region of Namibia

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