Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 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:

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's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Tuesday, April 25, 2017

Effects of transferring to the rehabilitation ward on long-term mortality rate of first-time stroke survivors: a population-based study

With no measurement of 30day deaths among these groups this research wasted a useful research point.
http://www.archives-pmr.org/article/S0003-9993%2817%2930244-7/abstract

Abstract


Objective

To assess the long-term health outcomes of acute stroke survivors transferred to the rehabilitation ward.

Design

Long-term mortality rates of first-time stroke survivors during hospitalization were compared among the following sets of patients: patients transferred to the rehabilitation ward (RR), patients receiving rehabilitation without being transferred to the rehabilitation ward (NtR), and patients receiving no rehabilitation (NoR).

Setting

We conducted a five-year, nationwide, population-based, retrospective, cohort study, using data from the Longitudinal Health Insurance Database 2005 in Taiwan.

Participants

A total of 11,419 patients with stroke from 2005 to 2008 were initially assessed for eligibility. After propensity score matching, 390 first-time stroke survivors were included.

Intervention

None.

Main Outcome Measures

The Cox proportional hazards regression model was used to assess differences in 5-year post-stroke mortality rates.

Results

Based on adjusted hazard ratios (HR), the NtR (adjusted HR = 2.20; 95% confidence interval (CI): 1.36–3.57) and NoR (adjusted HR = 4.00; 95% CI: 2.55–6.27) groups had significantly higher mortality risk than the RR group. Mortality rate of these stroke survivors was affected by age ≥ 65 years (compared to age < 45 years, adjusted HR = 3.62), men (adjusted HR = 1.49), ischemic stroke (adjusted HR = 1.55), stroke severity (Stroke Severity Index (SSI) ≥20, compared to SSI <10, adjusted HR = 2.68), and comorbidity (Charlson–Deyo Comorbidity Index (CCI) ≥3, compared to CCI = 0, adjusted HR = 4.23).

Conclusions

First-time stroke survivors transferred to the rehabilitation ward had a 5-year mortality rate 2.2 times lower than those who received rehabilitation without transfer to the rehabilitation ward and 4 times lower than those who received no rehabilitation.

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