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(Stroke. 2007;38:1727.)
© 2007 American Heart Association, Inc.

Editorials

Poststroke Care

Chronicles of a Neglected Battle

Gustavo Saposnik, MD, MSc Moira K. Kapral, MD, MSc

From the Stroke research Unit (G.S.), Division of Neurology, Department of Medicine, St. Michael’s Hospital, University of Toronto, Canada; the Mobility Program (G.S.), Clinical Research Unit, Department of Medicine, Toronto, Canada; the Department of Medicine and Health Policy (M.K.K.), Management and Evaluation, University of Toronto; Division of General Internal Medicine and Clinical Epidemiology and Women’s Health Program, University Health Network, Canada; and the Institute for Clinical Evaluative Sciences (ICES) (M.K.K.), Toronto, Canada.

Correspondence to Dr Gustavo Saposnik, 55 Queen St EAST, Suite 9-31, Toronto, ON-M5C 1R6 Canada. E-mail saposnikg@smh.toronto.on.ca

See related article, pages 1899–1904.

Key Words: stroke • mortality • outcome research • rehospitalization • Health policy • health services research • hospital admissions • cerebrovascular disease

An extract of the first 250 words of the full text is provided, because this article has no abstract.

"Thinking is easy, acting is difficult, and to put one’s thoughts into action is the most difficult thing in the world".

— —Goethe (1749–1832)

Major advances in acute stroke management have been seen over the past decade, including the use of thrombolysis, antithrombotic therapy, and organized in-hospital stroke care. However, relatively few studies have evaluated the effectiveness of these interventions in routine clinical practice, or have assessed issues related to delivery of services, access to care, and long-term care after discharge from stroke.

In this issue of Stroke, Bravata et al¹ contribute to our understanding of outcomes after stroke by analyzing readmissions and deaths in the first 5 years after a hospitalization for stroke. The target population included stroke survivors aged over 65 years who were Medicare beneficiaries and who were discharged from Connecticut acute care hospitals in 1995. This population was followed from discharge in 1995 through 2000 using Medicare claims and Social Security Administration mortality data. Among 2603 patients discharged alive, 40% were readmitted at least once within the first year of discharge, 53% had died or been readmitted within 1 year and only 15% survived admission-free for 5 years. Leading causes for readmission included pneumonia (8.2% to 9.0%), stroke (3.9% to 6.1%) and acute myocardial infarction (4.2% to 6.0%). There was no apparent association between length of hospital stay and readmission rate (unreported data kindly provided by the authors, 2007), and no information was available on potential patient and system factors associated with higher hospital readmission . . . [Full Text of this Article]

Related Article:

Readmission and Death After Hospitalization for Acute Ischemic Stroke: 5-Year Follow-Up in the Medicare Population

Dawn M. Bravata, Shih-Yieh Ho, Thomas P. Meehan, Lawrence M. Brass, and John Concato
Stroke 2007 38: 1899-1904. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

				R. F. Lyons, A. G. Rudd, and C. Alvaro Advances in Health Policy 2007 Stroke, February 1, 2008; 39(2): 264 - 267. [Full Text] [PDF]