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(Stroke. 2006;37:276.)
© 2006 American Heart Association, Inc.

Cochrane Corner

Services for Reducing the Duration of Hospital Care for Acute Stroke Patients

From the Academic Section of Geriatric Medicine, Glasgow, UK.

Correspondence to Peter Langhorne, PhD, FRCP, Academic Section of Geriatric Medicine, Third Floor University Block, Royal Infirmary, Glasgow, UK G31 2ER. E-mail pl11m@clinmed.gla.ac.uk

Key Words: hospitalization • randomized controlled trials • rehabilitation

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

	Introduction

 
In most developed countries, stroke patients are admitted to hospital for a period of acute care and rehabilitation. Services have been developed to try and accelerate discharge home and reduce the duration of hospital stay. These have been termed early supported discharge (ESD) services.

	Objectives

 
This review tested whether ESD services could reduce length of stay and improve patient outcome compared with conventional hospital care and discharge arrangements.

	Search Strategy

 
We searched the Cochrane Specialist Register of Controlled Trials (to August 2004). The contact trialist of all eligible studies was then contacted and asked to provide details of their intervention and control services and to provide individual patient data.

	Selection Criteria

 
We included randomized controlled trials (RCTs) that compared an ESD service with conventional care for hospitalized stroke patients. The aim of the ESD service was to accelerate discharge from hospital and provide rehabilitation and support in a community setting.

	Outcomes

 
The primary outcome was the composite end point of death or dependence (Barthel index <19/20 or Rankin score >2) recorded at the end of scheduled follow-up. Secondary outcomes were death, death or requiring long-term institutional care, activities of daily living (ADL) score, subjective health status, mood or depression, patient satisfaction, caregiver outcomes (subjective health status, mood score, satisfaction), and resource outcomes (length of stay and hospital readmission).

	Main Results

 
We identified 11 RCTs (n=1597 participants) that met the selection criteria. Nine RCTs used concealed randomization procedures and 10 used blinded outcome assessment. Median follow-up was 6 months (range 3 to 12 months). In 7 trials, a single . . . [Full Text of this Article]