Deans' stroke musings: Discharge home after acute stroke: Differences between older and younger patients

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, January 2, 2016

Discharge home after acute stroke: Differences between older and younger patients

Completely and totally the wrong conclusion. The solution you would have to propose is that before your stroke you get a caring and loving spouse. The goal should be 100% return to home. You haven't even identified the problem. The problem is that stroke rehab is a total fucking failure. You solve that by not having to provide very much of it. And that is by researching and creating protocols that stop the neuronal cascade of death in the first week.
http://www.ncbi.nlm.nih.gov/pubmed/26667264

Dutrieux RD¹, van Eijk M, van Mierlo ML, van Heugten CM, Visser-Meily JM, Achterberg WP.

Author information

Abstract

OBJECTIVE:

To identify determinants for discharge destination of older (≥ 70 years) and younger (< 70 years) acute stroke patients.

DESIGN:

Multicentre prospective cohort.

PATIENTS:

A total of 395 patients, within 7 days of clinically evaluated stroke, were included from 6 hospital stroke units.

METHODS:

The main outcome measure was discharge destination (home vs clinical rehabilitation). Independent variables were: demographic factors, stroke characteristics, functional impairments and disabilities, cognition, comorbidity, and premorbid social participation. Multivariate logistic regression analysis established the independent strength of the contribution of possible determinants to discharge destination.

RESULTS:

Seventy-six percent of younger patients were discharged home, compared with 63% of older patients. Most of the younger patients discharged to clinical rehabilitation (71%) had a spouse, whereas only 40% of the older age group discharged to clinical rehabilitation had a spouse. Multivariate analysis showed that, besides National Institutes of Health Stroke Scale and Barthel Index scores, having a spouse was an important determinant for discharge home in the older age group (adjusted odds ratio 4.77, 95% confidence interval 2.01-11.31), but not in the younger age group.

CONCLUSION:

The presence of a spouse is an additional important factor determining discharge home in older stroke patients. It is important to monitor and support informal caregivers in order to provide appropriate care for older community-dwelling stroke patients.

PMID:: 26667264; [PubMed - as supplied by publisher]

Deans' stroke musings