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Stroke discharges from a rehabilitation unit: 1-year and 5-year domicile outcomes. Function is important

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Abstract Background:

Stroke units save lives, reduce disability and increase the chances of the person returning to their own home. Following the introduction of a stroke rehabilitation unit, we assessed the durability of stroke discharges over a 1-year period and predictors of early ‘failed’ home discharges. Stability of discharge domicile and survival over 5 years was also reviewed. Methods:

A 6-month cohort of all discharges was followed for 5 years. Changes in domicile, including entry into institutional care, were recorded out to 5 years or until death. Predictors of early (3 months) and later (1 year) discharge stability were assessed. Results:

There were 142 discharges. Fifty-eight (76%) of those who returned home were still at home 12 months later. In contrast, there was a high mortality of dependent patients who were discharged to high dependency care (9 (29%) and 13 (42%) at 3 and 12 months, respectively). The chance of an early failed discharge was associated with lower functional ability on discharge (P= 0.012). Lower function on discharge was also independently associated with death in the next 12 months (P < 0.0001). At 5 years the mortality for the whole sample was 55% (78 of 141) and 38 (61%) of the survivors still lived in the community whereas 24 (39%) resided in institutional care. Conclusion:

Functional ability on discharge is a key predictor of ability to remain at home as well as survival and therefore every effort should be made to maximize function.

Keywords: discharge stability; function; rehabilitation; stroke

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1445-5994.2008.01844.x

Affiliations: Older Persons Health, The Princess Margaret Hospital and

Publication date: January 1, 2010

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