What followup is going to occur for the massive failures in recovery seen in this trial? Since we have NO LEADERSHIP AND NO STRATEGY, absolutely nothing will occur. The takeaway is don't have a stroke while young, or actually any time. In the business world failures are addressed and fixed, obviously the stroke medical world has no business sense at all.
Exploring post acute rehabilitation service use and outcomes for working age stroke survivors (≤65 years) in Australia, UK and South East Asia: data from the international AVERT trial
- Rosy Walters1,2,
- http://orcid.org/0000-0003-2950-4870Janice M Collier2,
- Lillian Braighi Carvalho2,
- Peter Langhorne3,
- Md Ali Katijjahbe4,5,
- Dawn Tan6,
- Marj Moodie7,
- http://orcid.org/0000-0002-2787-8484Julie Bernhardt2
- AVERT Trialists’ Collaboration
Author affiliations
Abstract
Objectives
Information about younger people of working age (≤65 years), their post
stroke outcomes and rehabilitation pathways can highlight areas for
further research and service change. This paper describes: (1) baseline
demographics; (2) post acute rehabilitation pathways; and (3) 12-month
outcomes; disability, mobility, depression, quality of life, informal
care and return to work of working age people across three geographic
regions (Australasia (AUS), South East (SE) Asia and UK).
Design
This post hoc descriptive exploration of data from the large
international very early rehabilitation trial (A Very Early
Rehabilitation Trial (AVERT)) examined the four common post acute
rehabilitation pathways (inpatient rehabilitation, home with community
rehabilitation, inpatient rehabilitation then community rehabilitation
and home with no rehabilitation) experienced by participants in the 3
months post stroke and describes their 12-month outcomes.
Setting Hospital stroke units in AUS, UK and SE Asia.
Participants Patients who had an acute stroke recruited within 24 hours who were ≤65 years.
Results
668 participants were ≤65 years; 99% lived independently, and 88% no
disability (modified Rankin Score (mRS)=0) prior to stroke. We had
complete data for 12-month outcomes for n=631 (94%). The proportion
receiving inpatient rehabilitation was higher in AUS than other regions
(AUS 52%; UK 25%; SE Asia 23%), whereas the UK had higher community
rehabilitation (UK 65%; AUS 61%; SE Asia 39%). At 12 months, 70% had no
or little disability (mRS 0–2), 44% were depressed, 28% rated quality of
life as poor or worse than death. For those working prior to stroke
(n=228), only 57% had returned to work. A noteworthy number of working
age survivors received no rehabilitation services within 3 months post
stroke.
Conclusions
There was considerable variation in rehabilitation pathways and post
acute service use across the three regions. At 12 months, there were
high rates of depression, poor quality of life and low rates of return
to work.
Trial registration number Australian New Zealand Clinical Trials Registry (ACTRN12606000185561).
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