Saturday, December 19, 2015

A comparison of stroke rehabilitation; data from two national cohorts

More proof that worldwide everything in stroke is fucked up. No standards for anything. You're screwed as a stroke survivor wherever you live.
http://onlinelibrary.wiley.com/doi/10.1111/ane.12542/abstract;jsessionid=F1FABB4706C160DE11D0DA4F08375696.f02t02?userIsAuthenticated=false&deniedAccessCustomisedMessage=
  1. G. Bērziņa1,*,
  2. A. Vētra1 and
  3. K.S. Sunnerhagen2
Article first published online: 15 DEC 2015
DOI: 10.1111/ane.12542
Article has an altmetric score of 4

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Keywords:

  • activities of daily living;
  • stroke;
  • complex interventions;
  • length of stay;
  • rehabilitation;
  • shift analysis

Objectives

Inpatient rehabilitation is a commonly used complex intervention to improve a person's independence after stroke. Evaluation and comparison of the effects of routine clinical practice could provide a contribution towards optimization of stroke care. The aim of this study is to describe results of inpatient rehabilitation as a complex intervention for persons after stroke and explore possible differences between two countries.

Methods

Data from 1055 Latvian and 1748 Swedish adult patients after stroke receiving inpatient rehabilitation, during 2011–2013, were used for this retrospective cohort study. Qualitative description of systems, as well as information on basic medical and sociodemographic information, and organizational aspects were reported. Change in the Functional Independence Measure during rehabilitation was investigated. In six domains of the instrument, the shifts for three levels of dependence were analysed using ordinal regression analysis.

Results

The components of stroke care seem to be similar in Latvia and Sweden. However, the median time since stroke onset until the start of rehabilitation was 13 weeks in Latvia and 2 weeks in Sweden. The median length of rehabilitation was 12 and 49 days, respectively. The level of dependency at start, time since stroke onset and length of the period had an impact on the results of the rehabilitation.

Conclusions

Although components of the rehabilitation are reported as being the same, characteristics and the outcome of the inpatient rehabilitation are different. Therefore, comparison of stroke rehabilitation between countries requires caution.
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