Abstract
Background and purpose: Data on patient-specific recovery after stroke are lacking
and the effects of complex healthcare interventions on the course of recovery were not
reported. To quantify the recovery pattern up to 1 year post-stroke and assess effects
of evidence-based treatments on the patient-specific course of recovery allowing its
prediction.
Methods: A total of 355 patients after first-ever stroke from the population-based
South London Stroke Register (source population >270 000) participated in a substudy
between August 2002 and October 2004. At 1, 2, 3, 4, 6, 8, 12, 26, and 52 weeks
post-stroke, Barthel Index (BI; ranging from 0 to 20) was documented. Multilevel
growth models allowing predictions for patients with specific characteristics were
calculated.
Results: Mean age was 70 years, 48% were male and 23% died within the first year.
The age-, gender- and stroke subtype-adjusted BI curve sharply increased until week 8
to 24 depending on patient characteristics and subsequently plateaued. Multivariable
analysis identified stroke unit care, appropriate secondary prevention and physiotherapy
for those with disabilities as independent predictors of improved functional
ability over time (P <0.05). Patients receiving stroke unit care additionally gained 4
BI points within 6 months compared with their counterparts (P = 0.004).
Conclusions: Functional outcome in the general population showed an increase followed
by a plateau. Care parameters reflecting guideline treatment independently
improved recovery illustrating the beneficial effects of evidence-based interventions on
recovery in an unbiased population.
Translated title of the contribution | Patient-specific recovery patterns over time measured by dependence in activities of daily living after stroke and post-stroke care: The South London Stroke Register (SLSR) |
---|---|
Original language | English |
Pages (from-to) | 1 - 7 |
Number of pages | 8 |
Journal | European Journal of Neurology |
DOIs | |
Publication status | Published - Jul 2009 |