What predicts a poor outcome in older stroke survivors? A systematic review of the literature.

Well shit, if we had a decent strategy and plan for stroke we wouldn't pay for  this kind of research. We'd go directly to solving and preventing dead and damaged neurons during the neuronal cascade of death. 
http://search.naric.com/research/rehab/redesign_record.cfm?search=2&type=all&criteria=J67331&phrase=no&rec=123147
NARIC Accession Number: J67331.  What's this?
ISSN: 0963-8288.
Author(s): van Almenkerk, Suzanne; Smalbrugge, Martin; Depla, Marja F. I. A.; Eefsting, Jan A.; Hertogh, Cees M. P. M..
Publication Year: 2013.
Number of Pages: 9.
Abstract: This review identified factors in the early post-stroke period that have a predictive value for a poor outcome, defined as institutionalization or severe disability. MEDLINE, PSYCINFO, EMBASE and CINAHL databases were systematically searched for observational cohort studies in which adult and/or elderly stroke patients were assessed within 1 month post-stroke and poor outcome was determined after a follow-up of at least 3 months. Thirty-three articles were selected from 4063 records, describing 27 independent cohort studies. There are rather consistent findings that greater age, a more severe stroke (measured through a clinical evaluation scale), the presence of urinary incontinence (with impaired awareness), and a larger stroke volume (measured through brain imaging techniques) predict poor stroke outcome. In contrast to clinical expectations, the prognostic value of dependency in activities of daily living and impaired cognition remains unclear, and factors in the domains of emotional and communicative functioning rarely feature. Studies using a selected group of stroke patients tended to identify different predictors. The current evidence is insufficient for the development of a clinical prediction tool that is better than physicians’ informal predictions. Future research should focus on the selection of optimal screening instruments in multiple domains of functioning, including the timing of assessment. The authors suggest developing prediction tools stratified by more homogeneous, clinically distinguished stroke subtypes.
Descriptor Terms: CLIENT CHARACTERISTICS, INSTITUTIONALIZATION, LITERATURE REVIEWS, MEDICAL ASPECTS, OLDER ADULTS, OUTCOMES, PREDICTION, SEVERE DISABILITIES, STROKE.