Article

OBJECTIVE: To identify determinants for discharge destination of older (>/= 70
years) and younger (< 70 years) acute stroke patients.
DESIGN: Multicentre
prospective cohort.
PATIENTS: A total of 395 patients, within 7 days of
clinically evaluated stroke, were included from 6 hospital stroke units. METHODS:
The main outcome measure was discharge destination (home vs clinical
rehabilitation). Independent variables were: demographic factors, stroke
characteristics, functional impairments and disabilities, cognition, comorbidity,
and premorbid social participation. Multivariate logistic regression analysis
established the independent strength of the contribution of possible determinants
to discharge destination. RESULTS: Seventy-six percent of younger patients were
discharged home, compared with 63% of older patients. Most of the younger
patients discharged to clinical rehabilitation (71%) had a spouse, whereas only
40% of the older age group discharged to clinical rehabilitation had a spouse.
Multivariate analysis showed that, besides National Institutes of Health Stroke
Scale and Barthel Index scores, having a spouse was an important determinant for
discharge home in the older age group (adjusted odds ratio 4.77, 95% confidence
interval 2.01-11.31), but not in the younger age group. CONCLUSION: The presence
of a spouse is an additional important factor determining discharge home in older
stroke patients. It is important to monitor and support informal caregivers in
order to provide appropriate care for older community-dwelling stroke patients.

Langue : ANGLAIS