Early supported discharge services for stroke patients: a meta-analysis of individual patients' data.
Background: Stroke patients conventionally undergo a substantial part of their rehabilitation in hospital. Services have been developed that offer patients early discharge from hospital with rehabilitation at home (early supported discharge [ESD]). We have assessed the effects and costs of such serv...
| Publicado en: | Lancet Vol. 365; no. 9458; pp. 501 - 507 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Lancet
2/5/2005
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106502954&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106502954 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01406736 LAN jtl: Lancet issn: 01406736 maglogo: N pubinfo: dt: 2/5/2005 vid: 365 iid: 9458 pid: 1297 pub: Lancet place: Philadelphia, Pennsylvania artinfo: ui: 106502954 106502954 NLM15705460 2005122644 10.1016/s0140-6736(05)17868-4 NLM15705460 106502954 ppf: 501 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Early supported discharge services for stroke patients: a meta-analysis of individual patients' data. aug: au: Langhorne P Taylor G Murray G Dennis M Anderson C Bautz-Holter E Dey P Indredavik B Mayo N Power M Rodgers H Ronning OM Rudd A Suuwanwela N Widen-Holmqvist L Wolfe C Langhorne, Peter Taylor, Gillian Murray, Gordon Dennis, Martin affil: Academic Section of Geriatric Medicine, Level 3, Centre Block, Royal Infirmary, Glasgow G4 OSF, UK sug: subj: Stroke Rehabilitation Early Patient Discharge Home Rehabilitation Stroke Patients Activities of Daily Living Aged Barthel Index Chi Square Test Clinical Assessment Tools Clinical Trials Confidence Intervals Length of Stay Medical Practice, Evidence-Based Meta Analysis Multidisciplinary Care Team Odds Ratio Patient Satisfaction Stroke Units Funding Source Human Aged: 65+ years ab: Background: Stroke patients conventionally undergo a substantial part of their rehabilitation in hospital. Services have been developed that offer patients early discharge from hospital with rehabilitation at home (early supported discharge [ESD]). We have assessed the effects and costs of such services. Methods: We did a meta-analysis of data from individual patients who took part in randomised trials that recruited patients with stroke in hospital to receive either conventional care or any ESD service intervention that provided rehabilitation and support in a community setting with the aim of shortening the duration of hospital care. The primary outcome was death or dependency at the end of scheduled follow-up. Findings: Outcome data were available for 11 trials (1597 patients). ESD services were mostly provided by specialist multidisciplinary teams to a selected group (median 41%) of stroke patients admitted to hospital. There was a reduced risk of death or dependency equivalent to six (95% CI one to ten) fewer adverse outcomes for every 100 patients receiving an ESD service (p=0.02). The hospital stay was 8 days shorter for patients assigned ESD services than for those assigned conventional care (p<0.0001). There were also significant improvements in scores on the extended activities of daily living scale and in the odds of living at home and reporting satisfaction with services. The greatest benefits were seen in the trials evaluating a coordinated multidisciplinary ESD team and in stroke patients with mild to moderate disability. Interpretation: Appropriately resourced ESD services provided for a selected group of stroke patients can reduce long-term dependency and admission to institutional care as well as shortening hospital stays. pubtype: Academic Journal doctype: research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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