Stroke rehabilitation in the elderly: analysis of six years' experience

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Abstract
Objective: To evaluate changes to a system consisting of a stroke unit and a stroke registry to follow elderly stroke subjects from admission until six months poststroke. Methods: The inputs, outputs and outcomes of stroke for all persons aged 60 and above were measured over six years (1987-92). Results: An average of 212 persons with acute stroke were registered each year. Demographic features of stroke subjects did not change appreciably during the six-year study period. Indices of stroke severity and case fatality remained similar. Hospital length of stay, however, fell by 45% from 1987 to 1992 (p <0.0001) without any decline in functional outcome, as measured by Barthel ADL scores at discharge or maximal recovery and discharge residence. The percentage of subjects transferred to the stroke unit rose from 43% in 1987 to 64% in 1992. The stroke unit operated with minimal selection. Conclusions: Stroke units using minimal selection criteria warrant further study as an alternative to more highly selective stroke units.