Early supported discharge services for stroke patients: a meta-analysis of individual patients' data

P Langhorne, G Taylor, G Murray, M Dennis, C Anderson, E Bautz-Holter, P Dey, B Indredavik, N Mayo, M Power, H Rodgers, O M Ronning, A Rudd, N Suwanwela, L Widen-Holmqvist, C Wolfe

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234 Citations (Scopus)

Abstract

Background Stroke patients conventionally undergo a substantial part of their rehabilitation in hospital. Services have been developed that offer patients early discharge from hospital with rehabilitation at home (early supported discharge [ESD]). We have assessed the effects and costs of such services. Methods We did a meta-analysis of data from individual patients who took part in randomised trials that recruited patients with stroke in hospital to receive either conventional care or any ESD service intervention that provided rehabilitation and support in a community setting with the aim of shortening the duration of hospital care. The primary outcome was death or dependency at the end of scheduled follow-up. Findings Outcome data were available for 11 trials (1597 patients). ESD services were mostly provided by specialist multidisciplinary teams to a selected group (median 41%) of stroke patients admitted to hospital. There was a reduced risk of death or dependency equivalent to six (95% Cl one to ten) fewer adverse outcomes for every 100 patients receiving an ESD service (p=0.02). The hospital stay was 8 days shorter for patients assigned ESD services than for those assigned conventional care (p
Original languageEnglish
Pages (from-to)501 - 506
Number of pages6
JournalThe Lancet
Volume365
Issue number9458
DOIs
Publication statusPublished - 5 Feb 2005

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