Stroke discharges from a rehabilitation unit: 1-year and 5-year domicile outcomes. Function is important
Article first published online: 11 NOV 2008
© 2010 The Authors. Journal compilation © 2010 Royal Australasian College of Physicians
Internal Medicine Journal
Volume 40, Issue 1, pages 45–51, January 2010
How to Cite
Hanger, H. C., Wilkinson, T. J. and Mears, A. (2010), Stroke discharges from a rehabilitation unit: 1-year and 5-year domicile outcomes. Function is important. Internal Medicine Journal, 40: 45–51. doi: 10.1111/j.1445-5994.2008.01844.x
Conflict of interest: None.
- Issue published online: 9 FEB 2010
- Article first published online: 11 NOV 2008
- Received 24 June 2008; accepted 25 September 2008.
- discharge stability;
Background: Stroke units save lives, reduce disability and increase the chances of the person returning to their own home. Following the introduction of a stroke rehabilitation unit, we assessed the durability of stroke discharges over a 1-year period and predictors of early ‘failed’ home discharges. Stability of discharge domicile and survival over 5 years was also reviewed.
Methods: A 6-month cohort of all discharges was followed for 5 years. Changes in domicile, including entry into institutional care, were recorded out to 5 years or until death. Predictors of early (3 months) and later (1 year) discharge stability were assessed.
Results: There were 142 discharges. Fifty-eight (76%) of those who returned home were still at home 12 months later. In contrast, there was a high mortality of dependent patients who were discharged to high dependency care (9 (29%) and 13 (42%) at 3 and 12 months, respectively). The chance of an early failed discharge was associated with lower functional ability on discharge (P= 0.012). Lower function on discharge was also independently associated with death in the next 12 months (P < 0.0001). At 5 years the mortality for the whole sample was 55% (78 of 141) and 38 (61%) of the survivors still lived in the community whereas 24 (39%) resided in institutional care.
Conclusion: Functional ability on discharge is a key predictor of ability to remain at home as well as survival and therefore every effort should be made to maximize function.