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Survival and outcomes for stroke survivors living in care homes: a prospective cohort study.
Clery, Amanda; Martin, Finbarr C; Redmond, Patrick; Marshall, Iain; McKevitt, Christopher; Sackley, Catherine; Manthorpe, Jill; Wolfe, Charles; Wang, Yanzhong.
Afiliación
  • Clery A; Department of Population Health Sciences, School of Population Health and Environmental Sciences, King's College London, London, UK.
  • Martin FC; Department of Population Health Sciences, School of Population Health and Environmental Sciences, King's College London, London, UK.
  • Redmond P; Department of Population Health Sciences, School of Population Health and Environmental Sciences, King's College London, London, UK.
  • Marshall I; Department of Population Health Sciences, School of Population Health and Environmental Sciences, King's College London, London, UK.
  • McKevitt C; Department of Population Health Sciences, School of Population Health and Environmental Sciences, King's College London, London, UK.
  • Sackley C; Department of Population Health Sciences, School of Population Health and Environmental Sciences, King's College London, London, UK.
  • Manthorpe J; National Institute for Health Research Policy Research Unit in Health and Social Care Workforce, King's College London, London, UK.
  • Wolfe C; Department of Population Health Sciences, School of Population Health and Environmental Sciences, King's College London, London, UK.
  • Wang Y; National Institute for Health Research Biomedical Research Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Age Ageing ; 50(6): 2079-2087, 2021 11 10.
Article en En | MEDLINE | ID: mdl-34240106
ABSTRACT

BACKGROUND:

Stroke survivors living in care homes require high levels of support with everyday living. The aims of this study were to describe the survival, health status and care received by stroke survivors living in care homes at 1-year post-stroke, compared with those in their own homes.

METHODS:

A total of 3,548 stroke survivors with a first ever stroke between 1998 and 2017 in the South London Stroke Register were identified for survival analysis. A total of 2,272 were included in the 1-year follow-up analysis. Cox regression and Kaplan-Meier plots were used to describe survival, stratified into four 5-year cohorts. Health status, medications and rehabilitation received at 1-year post-stroke were compared using descriptive statistics.

RESULTS:

Over the 20-year period, survival improved for stroke survivors discharged to their own home (P < 0.001) but not for those discharged to care homes (P = 0.75). Care home residents were highly disabled (median Barthel index 6/20, interquartile range 2-10). Rates of secondary stroke prevention medications at 1-year follow-up increased over time for care home residents, including antiplatelets from 12.3 to 38.1%, although still lower than for those in their own homes (56.3%). Speech and language problems were common in the care home population (40.0%), but only 16% had received speech and language therapy.

CONCLUSIONS:

Rates of secondary stroke prevention prescribing increased over 20 years but remained lower in care home residents. The lower levels of rehabilitation received by stroke survivors in care homes, despite their higher levels of disability, suggest a gap in care and urgent need for restorative and/or preventative rehabilitation.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Accidente Cerebrovascular / Rehabilitación de Accidente Cerebrovascular Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Age Ageing Año: 2021 Tipo del documento: Article País de afiliación: Reino Unido

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Accidente Cerebrovascular / Rehabilitación de Accidente Cerebrovascular Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Age Ageing Año: 2021 Tipo del documento: Article País de afiliación: Reino Unido