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Cited by 66Stroke Rehabilitation and RecoveryAcute Ischemic Stroke ManagementMedical Practices and Rehabilitation

Stroke Unit Care Combined With Early Supported Discharge Improves 5-Year Outcome: A Randomized Controlled Trial

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Fjærtoft, Hild, Rohweder, Gitta, Indredavik, Bent·2011·Stroke
DOI 10.1161/strokeaha.110.601153
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Abstract

Background and Purpose—: Early supported discharge (ESD) seems to be a promising alternative to conventional follow-up care after acute stroke. We have previously shown that stroke unit care combined with ESD has beneficial effects on functional outcome and the use of resources for up to 1 year. The aim of this trial was to evaluate outcome after 5 years. Methods—: We performed a randomized controlled trial with 320 acute stroke patients allocated to ordinary stroke unit care (160 patients) or stroke unit care with ESD (160 patients). The ESD service consisted of a mobile team that co-coordinated hospital discharge and further rehabilitation during 1 month of follow-up in cooperation with the primary health care. Mortality, residence, and functional outcome including modified Rankin scale were registered after 5 years. All assessments were blinded. Results—: There was no difference between the groups with modified Rankin scale score ≤2 ( P =0.213), but there was a trend toward greater improvement in modified Rankin scale score in the ESD group from onset of stroke (38% versus 30%; P =0.106). More patients were dead or institutionalized in the ordinary stroke unit care group ( P =0.032); 158 patients were alive, 84 were in ESD, and 74 were in ordinary stroke unit care. Of the 158 patients alive, a greater proportion were living at home in ESD (86%/70%; P =0.019). Conclusions—: Stroke unit care combined with ESD seems to reduce death and institutional care and to improve patients' chances of living at home 5 years after stroke compared to traditional stroke care. There is a trend toward improved functional outcome in the ESD group.

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  • Literature addressing OT interventions for stroke survivors going home on discharge shows that most are effective in terms of patients' functional recovery and caregivers' improvements in self-efficacy and fatigue reduction, but heterogeneity of the interventions precludes drawing specific conclusions.

    “Overall, literature addressing OT interventions for stroke survivors going home on discharge shows that, although most of them are effective in terms of patients’ functional recovery, as well as caregivers’ improvements in self-efficacy and fatigue reduction, the heterogeneity of the interventions precludes to draw specific conclusions [11–13].”

    From Early Occupational Therapy Intervention post-stroke (EOTIPS): A randomized controlled trial (2024) · cites this paper as [12]

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  1. Rankin J. Cerebral vascular accidents in patients over the age 60. Prog Scot Med J. 1957;2:200 -215.

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Authors
Fjærtoft, H., Rohweder, G., & Indredavik, B.
Affiliations
Norwegian University of Science and Technology (NO)
ORCID
Venue
Stroke
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2011-06
Volume
42
Issue
6
Pages
1707-1711
ISSN
  • 0039-2499 (ISSN-L)
  • 1524-4628
DOI
10.1161/strokeaha.110.601153
OpenAlex
W2024068146
Cited by
66
References
31
Citations by year
2026: 1 · 2025: 3 · 2024: 3 · 2023: 5 · 2022: 3 · 2021: 5 · 2020: 4 · 2019: 4 · 2018: 1 · 2017: 3 · 2016: 7 · 2015: 6 · 2014: 10 · 2013: 4 · 2012: 7
FWCI
6.81
Type
journal article
Language
en
Open access
Locations
  • Stroke (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Keywords
acute stroke, stroke unit care, early supported discharge, long-term outcomes, functional outcome, modified Rankin Scale, mortality, institutionalization, living at home, primary care, stroke rehabilitation
MeSH terms
Stroke Rehabilitation, Aged, Follow-Up Studies, Home Care Services, Hospital Units, Humans, Male, Neuropsychological Tests, Norway, Patient Discharge, Treatment Outcome

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