Stroke, Vol 25, 346-351, Copyright © 1994 by American Heart Association
L Kalra
BACKGROUND AND PURPOSE: The influence of age on benefits of stroke unit
rehabilitation is largely unknown. METHODS: A prospective controlled study
was undertaken in 245 stroke survivors randomized to a stroke unit or to
general wards 2 weeks after stroke. Patients were divided into older (75
years and over) and younger (under 75 years) age groups, and their
characteristics, prognosis, duration, and type of therapy input and outcome
were compared in different settings. RESULTS: Younger (n = 101) and older
(n = 144) stroke patients were comparable for neurological and functional
deficits and were distributed equally between the stroke unit and general
wards. The duration of therapy input was similar in younger patients in
either setting. Older patients received more occupational therapy in both
settings (10.7 +/- 2.4 versus 7.9 +/- 04.1) and more physiotherapy (18.4
+/- 9.6 versus 15.2 +/- 7.8) on general wards. Younger patients on the
stroke unit showed better outcome compared with those on general wards
(discharge home, 83% versus 60%; median Barthel score, 17 versus 13; median
length of hospital stay, 27 versus 56 days) and with older patients on the
stroke unit (discharge home, 83% versus 65%; median Barthel score, 17
versus 14). Outcome in older stroke patients was similar in both settings
except for a shorter median length of hospital stay on the stroke unit (36
versus 84 days). Outcome in younger patients managed on general wards was
worse than that in older patients with similar prognostic expectations
(discharge home, 41% versus 61%; median Barthel score, 11 versus 13).
CONCLUSIONS: Younger stroke patients benefited more by stroke unit
rehabilitation compared with older patients, not only because of their age
but also because of differences in the multidisciplinary input available
for elderly patients outside the stroke unit.
ARTICLES
Does age affect benefits of stroke unit rehabilitation?
Orpington Stroke Unit, Bromley Hospitals, England, UK.
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