Alternative strategies for stroke care: a prospective randomised controlled trial.
Background: Organised specialist care for stroke improves outcome, but the merits of different methods of organisation are in doubt. This study compares the efficacy of stroke unit with stroke team or domiciliary care. Methods: A single-blind, randomised, controlled trial was undertaken in 457 acute...
| Publicado en: | Lancet Vol. 356; no. 9233; pp. 894 - 900 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Lancet
9/9/2000
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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=106991938&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106991938 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01406736 LAN jtl: Lancet issn: 01406736 maglogo: N pubinfo: dt: 9/9/2000 vid: 356 iid: 9233 pid: 1297 pub: Lancet place: Philadelphia, Pennsylvania artinfo: ui: 106991938 106991938 NLM11036894 2001004306 10.1016/s0140-6736(00)02679-9 NLM11036894 106991938 ppf: 894 ppct: 6 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Alternative strategies for stroke care: a prospective randomised controlled trial. aug: au: Kalra L Evans A Perez I Knapp M Donaldson N Swift CG Kalra, L Evans, A Perez, I Knapp, M Donaldson, N Swift, C G affil: Department of Medicine, Guy's, King's and St Thomas's School of Medicine, London, UK sug: subj: Stroke Rehabilitation Multidisciplinary Care Team Rehabilitation Centers Home Rehabilitation Inpatients Outpatients Single-Blind Studies Odds Ratio Confidence Intervals Kruskal-Wallis Test Barthel Index Logistic Regression Kaplan-Meier Estimator Mortality Institutionalization Clinical Assessment Tools Cox Proportional Hazards Model Disability Evaluation Length of Stay Health Resource Utilization Male Female Aged Aged, 80 and Over Outcomes (Health Care) Acute Care Funding Source Human Aged: 65+ years Aged, 80 & over Male Female ab: Background: Organised specialist care for stroke improves outcome, but the merits of different methods of organisation are in doubt. This study compares the efficacy of stroke unit with stroke team or domiciliary care. Methods: A single-blind, randomised, controlled trial was undertaken in 457 acute-stroke patients (average age 76 years, 48% women) randomly assigned to stroke unit, general wards with stroke team support, or domiciliary stroke care, within 72 h of stroke onset. Outcome was assessed at 3, 6, and 12 months. The primary outcome measure was death or institutionalisation at 12 months. Analyses were by intention to treat. Findings: 152 patients were allocated to the stroke unit, 152 to stroke team, and 153 to domiciliary stroke care. 51 (34%) patients in the domiciliary group were admitted to hospital after randomisation. Mortality or institutionalisation at 1 year were lower in patients on a stroke unit than for those receiving care from a stroke team (21/152 [14%] vs 45/149 [30%]; p<0.001) or domiciliary care (21/152 [14%] vs 34/144 [24%]; p=0.03), mainly as a result of reduction in mortality. The proportion of patients alive without severe disability at 1 year was also significantly higher on the stroke unit compared with stroke team (129/152 [85%] vs 99/149 [66%]; p<0.001) or domiciliary care (129/152 [85%] vs 102/144 [71%]; p=0.002). These differences were present at 3 and 6 months after stroke. Interpretation: Stroke units are more effective than a specialist stroke team or specialist domiciliary care in reducing mortality, institutionalisation, and dependence after stroke. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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