Randomised controlled trial to evaluate early discharge scheme for patients with stroke

Rudd, Anthony; Wolfe, Charles D.A.; Tilling, Kate; Beech, Roger

doi:10.1136/bmj.315.7115.1039

Cited by 186 publications

(159 citation statements)

References 18 publications

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“…Rudd et al reported the most widely dispersed admission scores for both the BI and MMSE; in this study, 1 standard deviation in scores ranged from 11 to 19 in the BI and 14 to 28 on the MMSE. 15 This wide variation in scores reflects more inclusive admission in this particular study that was not seen in the others. Across all eight trials, the majority of outcomes were either similar between ESD and the control group or in favour of ESD.…”

Section: The Canadian Journal Of Neurological Sciencesmentioning

confidence: 65%

“…Holmqvist et al explicitly used an MMSE score of 23 in their inclusion criteria 10 and two others reported average admission scores of 28 and 21, respectively. 6,15 In these three studies, the mean score on admission was 24/30. Similar to BI, the study with the widest dispersion of admission MMSE scores was Rudd et al, 15 in which 1 standard deviation from the mean ranged from 14 to 28.…”

Section: Discussionmentioning

confidence: 92%

“…6,15 In these three studies, the mean score on admission was 24/30. Similar to BI, the study with the widest dispersion of admission MMSE scores was Rudd et al, 15 in which 1 standard deviation from the mean ranged from 14 to 28. Cognitive function should be included in all screening criteria for ESD with automatic focus placed on patients with MMSE scores of 23 to 30, as was done by Holmqvist, whereas identifying patients with scores of 14 to 22 for further consideration.…”

Section: Discussionmentioning

confidence: 92%

“…The typical period of recruitment into ESD was between 8 and 14 days poststroke, with only two exceptions. 9,15 Mean length of participation in the ESD programs ranged from 30 days to 4 months across studies; however, this was generally shorter in more recent studies (post-2000), where all but one 9 reported ESD duration between 4 and 5 weeks.…”

Section: Resultsmentioning

confidence: 97%

“…In total, eight studies were included for further assessment. 6,[9][10][11][12][13][14][15] A summary of the programs explored in the studies of a team coordinated and delivered ESD program is provided in Table 1. All teams included a physiotherapist (PT) and occupational therapist (OT) and most included access to a speech language pathologist (SLP).…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

A Synthesis of Peer-Reviewed Literature on Team-Coordinated and Delivered Early Supported Discharge After Stroke

Meyer

Teasell

Thind

et al. 2016

Can. J. Neurol. Sci.

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This review aimed to summarize data from peer-reviewed studies of team-coordinated and delivered early supported discharge (ESD) for postacute, poststroke rehabilitation. A systematic review was performed in Medline, Embase, and CINAHL for appropriate studies. Information on program details and patient cohorts was synthesized. All programs sought patients with mild-to-moderate functional impairment and minimal cognitive impairment (often based on Barthel Index and Mini-Mental State Examination scores, respectively). All also included at least one subjective admission criterion related to rehabilitation suitability or the suitability of the home environment. Based on the identified studies, ESD programs can assume that 15% of patients screened for ESD will be eligible and care should be provided for 4 to 5 weeks postdischarge. Although the benefits of team-coordinated and delivered ESD poststroke have been well-documented, this review may be helpful for clinicians, administrators, and policy makers looking to establish or refine an ESD program for stroke.RÉSUMÉ: Synthèse de la littérature revue par des pairs sur le congé hospitalier précoce avec soutien coordonné et fourni par une équipe de personnel soignant après un accident vasculaire cérébral. L'objectif de cette revue était de résumer les données des études revues par des pairs sur le congé hospitalier précoce avec soutien (CHPS) coordonné et fourni par une équipe de personnel soignant pour la réadaptation post aiguë après un accident vasculaire cérébral (AVC). Nous avons effectué une revue systématique dans les bases de données Medline, Embase et CINAHL pour identifier les études pertinentes. Nous avons effectué une synthèse de l'information sur les détails des programmes et sur les cohortes de patients. Tous les programmes visaient des patients ayant un déficit fonctionnel de léger à modéré et un déficit cognitif minime (souvent basé sur le score à l'indice de Barthel et au Mini-Mental State Examination respectivement). Tous incluaient également au moins un critère d'admission subjectif en lien avec l'adéquation du sujet et de son environnement domiciliaire à la réadaptation. D'après les études identifiées, les programmes de CHPS peuvent présumer que 15% des patients dépistés pour un CHPS y seront éligibles et que les soins devraient être prodigués pendant 4 à 5 semaines après le congé. Bien que les bénéfices du soutien coordonné et fourni par une équipe de personnel soignant après un CHPS aient été bien documentés, cette revue peut aider les cliniciens, les administrateurs et les décideurs qui prévoient établir ou perfectionner un tel programme pour l'AVC.

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Section: The Canadian Journal Of Neurological Sciencesmentioning

confidence: 65%