Early supported discharge after stroke
Early supported discharge after stroke
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DOI：
10.2340/16501977-0042
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发表时间：
2007-03-01
影响因子：
3.5
通讯作者：
Widen-Holmqvist, Lotta
中科院分区：
文献类型：
--
作者：
Langhorne, Peter;Widen-Holmqvist, Lotta
中风后的患者通常在医院接受大部分康复治疗。已经发展了一些服务，为病人提供早期出院和更多的在家康复（早期支持出院）。本文对所有关于早期支持出院服务的随机试验进行了系统回顾，其中包括12项试验（1659例患者）。对于每100例接受早期支持出院服务的患者，死亡或依赖的几率降低，相当于不良结局减少5例（95%置信区间1-10）（p = 0.04）。接受早期支持出院服务的患者显示住院时间缩短8天（p < 0.0001）。在评估协调的多学科早期支持出院团队和轻度至中度残疾患者的试验中观察到最大的益处。从斯德哥尔摩的试验经验，以探讨早期支持出院服务的潜在作用机制。最后，一个说明性的病例报告，说明了一个典型的病人路径在早期支持出院服务。
Patients after stroke conventionally receive much of their rehabilitation in hospital. Services have been developed that offer patients an early discharge from hospital with more rehabilitation at home (early supported discharge). This paper sets out a systematic review of all randomized trials of early supported discharge services that included 12 trials (1659 patients). There was a reduced odds of death or dependency equivalent to 5 fewer adverse outcomes (95% confidence interval 1-10) for every 100 patients receiving an early supported discharge service (p = 0.04). Patients receiving early supported discharge services showed an 8 day reduction (p < 0.0001) in the length of hospital stay. The greatest benefits were seen in the trials evaluating a co-ordinated multidisciplinary early supported discharge team and with patients with mild-moderate disability. The experience of a trial from Stockholm is described in order to explore the potential mechanism of action of early supported discharge services. In conclusion, an illustrative case report is set out, indicating a typical patient pathway in an early supported discharge service.