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Hospital re-admissions in relation to acute stroke unit care versus conventional care in elderly patients the first year after stroke: the Göteborg 70+ Stroke study.

Journal article
Authors Lisbeth Claesson
Gunilla Gosman-Hedström
Björn Fagerberg
Christian Blomstrand
Published in Age and ageing
Volume 32
Issue 1
Pages 109-13
ISSN 0002-0729
Publication year 2003
Published at Wallenberg Laboratory
Institute of Clinical Neurosciences, Section of Neurological Diseases
Institute of Internal Medicine, Dept of Medicine
Pages 109-13
Language en
Links www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Aged, Aged, 80 and over, Cerebrovascular Accident, complications, epidemiology, rehabilitation, Comorbidity, Female, Hospital Units, utilization, Humans, Length of Stay, statistics & numerical data, Male, Patient Readmission, statistics & numerical data, Risk Factors, Sweden, epidemiology
Subject categories Neurology

Abstract

BACKGROUND: re-hospitalisation after discharge following index stroke varies over time and with age and comorbidity. There is little knowledge about whether stroke unit care reduces the need of re-admissions. OBJECTIVES: to examine whether stroke unit care as compared with care in general medical wards was associated with fewer re-hospitalisations for conditions judged to be secondary to acute stroke and to identify the influence of stroke severity on re-admission rates. DESIGN:we conducted a one-year randomised study to compare the outcome of treatment at an acute stroke unit in a care continuum with the outcome of treatment at general medical wards. SETTINGS: acute and geriatric hospitals in Göteborg, Sweden. SUBJECTS: 216 elderly patients aged >or=70 years discharged to their own homes or to institutionalised living after index stroke. METHODS: comparison of comorbidity classified according to Charlson's morbidity index, re-admission rates, length of hospital stay, number of re-admissions and diagnoses between a group treated at a stroke unit and a group treated at general wards. RESULTS: the re-admission rates, length of hospital stay and causes of re-admissions did not differ between the two groups. Complications related to the damage to the brain and concomitant heart disease were the most common causes of re-admissions in both groups. Index stroke severity did not influence the re-admission rates. CONCLUSIONS: re-admissions for conditions judged to be secondary to acute stroke were equal in the two groups in this prospective study.

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