Stroke Unit at Home: A Prospective Observational Implementation Study for Early Supported Discharge from the Hospital

Bråndal, Anna; Wester, Per

doi:10.4172/2329-9096.1000170

Cited by 1 publication

(4 citation statements)

References 27 publications

(54 reference statements)

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“…Västerbotten County have three hospitals with different primary catchment areas that cared patients in acute and sub-acute phases of stroke. Two of these hospitals, the Umeå Stroke Center (university hospital) and Skellefteå hospital (community hospital) had similar organizations regarding stroke care Both hospitals had stroke unit care followed by ESD according to a previously described model [9]. These hospitals provided ESD to a comparatively large proportion of patients (41.2% at Umeå Stroke Center and 57.5% at Skellefteå hospital) compared to other hospitals in Sweden.…”

Section: Methodsmentioning

confidence: 99%

“…The model included important key elements for an effective ESD service [6, 8], such as a multidisciplinary team with experience in stroke rehabilitation, appropriate resources, periodic team meetings, and continuous evaluations of outcome with standardized measurements. Our previous results showed that ESD services reduced patient dependence in activities in daily living (ADL) and increased patient mobility, without increasing the risk of accidental falls or other injuries [9]. The patients were very satisfied with the ESD-service.…”

Section: Introductionmentioning

confidence: 93%

“…We previously described the method, content, and outcome of ESDs according to the Umeå Stroke Center model in Västerbotten County [9]. This model showed that it was possible to adopt and implement ESD for patients with stroke in Umeå.…”

Section: Introductionmentioning

confidence: 99%

“…The present study aimed to evaluate patient-reported outcomes measures (PROMs) among patients with stroke that received modern stroke unit care, and compare PROMs between those that received or did not receive ESD. The ESD was delivered according to a previously described model [9]. We hypothesized that patients that received ESD would exhibit improved PROMs regarding satisfaction with rehabilitation (primary outcome), activity in daily living (ADL), tiredness/fatigue, pain, dysthymia/depression, general health status and information about stroke (secondary outcomes) compared to controls.…”

Section: Introductionmentioning

confidence: 99%

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Effect of early supported discharge after stroke on patient reported outcome based on the Swedish Riksstroke registry

et al. 2019

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BackgroundThe efficacy of early supported discharge (ESD) has not been tested in current stroke care setting, which provide relatively short hospital stays, access to hyper-acute therapies and early carotid stenosis interventions. This study aimed to compare patient-reported outcome measures (PROM) among patients with stroke that received modern stroke unit care with or without ESD.MethodsObservational study of 30,232 patients with first-ever stroke registered in the Riksstroke registry in Sweden, between 1 January 2010 and 31 December 2013. Patient characteristics were collected from the Riksstroke and Statistics Sweden databases. The primary outcome was satisfaction with the rehabilitation at 3 months after discharge. Secondary outcome were information about stroke provided, tiredness/fatigue, pain, dysthymia/depression, general health status and dependence in activities of daily living (mobility, toileting and dressing) at 3 months after the stroke. We used separate multivariable logistic regression models for each PROM variable to analyze associations between PROMs and ESD/no ESD.ResultsThe ESD group comprised 1495 participants: the control group comprised 28,737 participants. Multivariable logistic regression models of PROMs showed that, compared to controls, the ESD group was more satisfied with rehabilitation after discharge (OR: 1.78, 95% CI: 1.17–2.49), experienced less dysthymia/depression (OR: 0.68, 95% 0.55–0.84) and showed more independence in mobility (OR: 1.50, 95% CI: 1.17–1.92), toileting (OR: 1.30, 95%CI: 1.05–1.61), and dressing (OR: 1.23, 95%CI: 1.02–1.48).ConclusionIn the setting of modern stroke unit care, ESD appeared to have positive effects on stroke rehabilitation, in the subacute phase.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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