Well it is incredibly obvious that stroke survivors don't need 'care'; they need 100% recovery protocols! GET THERE! Solve the correct problem; 100% recovery protocols, 'care' is useless.
Does implementation of a standardized pathway of stroke care affect functional outcome after stroke?
Abstract
Background:
A stroke care pathway (SCP) was introduced in Norway in 2018. The goal
of the pathway was to avoid delay in treatment and diagnostics of acute
stroke and to secure treatment according to national guidelines. In this
study, we aimed to evaluate how the implementation of the SCP affects
outcome after stroke.
Methods:
We performed a
register-based study using data from the Norwegian Stroke Register that
covers 87% of acute stroke patients in Norway.
Patients
included one year before and one year after the introduction of the
care pathway were compared (2017 versus 2019). Change in functional
outcome, the proportion of independent patients 90 days post-stroke,
discharge destination, proportions admitted to stroke units and 90 days
mortality were compared. Functional outcome was measured using modified
Rankin Scale (mRS) and functional independence was defined as mRS 0-2.
Results:
In total 11 009 patients with 90 days follow-up data were analysed.
Comparing the cohorts from 2017 and 2019 there was no change in
demographics or stroke characteristics. No statistically significant
differences in mRS, admission to thrombolysis time or 90 days mortality
were found. However, the proportion of patients discharged directly home
and treated in a stroke unit increased from 2017 to 2019.
Conclusion:
The implementation of a standardized pathway of stroke care in Norway,
did not lead to improvement in functional outcome or a reduction in 90
days mortality. However, the proportion of patients discharged directly
home increased, and more patients were treated in stroke units in 2019
compared to 2017.
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