LONG-TERM TRENDS IN CARE NEEDS OF STROKE SURVIVORS IN CARE HOMES AND PREDICTORS FOR DISCHARGE TO CARE HOMES

TY - JOUR

T1 - LONG-TERM TRENDS IN CARE NEEDS OF STROKE SURVIVORS IN CARE HOMES AND PREDICTORS FOR DISCHARGE TO CARE HOMES

AU - Clery, Amanda Louise

AU - Bisquera, Alessandra Ramos

AU - Bhalla, Ajay

AU - Sackley, Catherine Mary

AU - Wolfe, Charles David Alexander

AU - Wang, Yanzhong

PY - 2019/5/22

Y1 - 2019/5/22

N2 - Background and Aims: The care needs of stroke survivors discharged to care homes are increasing over time. We aim to assess the needs of and identify predictors for discharge to care homes.Methods: Using data from the South London Stroke Register between 1995 and 2014, first-ever stroke survivors were categorised into four cohorts: 1995–1999, 2000–2004, 2005–2009, 2010–2014. The baseline characteristics and 3-month follow-up care of each cohort were summarised and tested for trends over time. Multivariable logistic regression models determined associations between these factors and discharge to care homes.Results: Of 4,879 patients, 452 (10.1%) were discharged to care homes. This proportion decreased from 17.1% in 1995–1999 to 4.2% in 2010–2014. Over time, hospital stays shortened (median: 89–50 days, p<0.001) and stroke unit admissions increased (31.0-92.5%, p<0.001). The total number of 3-months post-stroke prescriptions also increased over time, including for clopidogrel (0.0-25.0%, p<0.001) and statins (1.7-45.0%, p<0.001), as well as physiotherapy(14.8-38.9%, p<0.001). However, over time the proportion of patients with a GCS score <13 has increased (29.1-48.6%, p¼0.005). Compared to patients discharged to their own homes, predictors of discharge to care homes include (odds ratio, 95% confidence interval): hospital stay of >60 days (15.9, 10.2-25.7), old age (5.8, 3.5-9.7), White ethnicity (1.7, 1.2-2.5), GCS <13 (2.0, 1.4-2.8), incontinence (1.8, 1.2-2.5), and a post-stroke BI <15 (3.7, 2.1-6.8).Conclusions: Over time, fewer but more severe stroke survivors are discharged to care homes with improved access to stroke interventions. Further research should investigate whether care homes are well equipped to meet the increasing needs of incoming patients.

AB - Background and Aims: The care needs of stroke survivors discharged to care homes are increasing over time. We aim to assess the needs of and identify predictors for discharge to care homes.Methods: Using data from the South London Stroke Register between 1995 and 2014, first-ever stroke survivors were categorised into four cohorts: 1995–1999, 2000–2004, 2005–2009, 2010–2014. The baseline characteristics and 3-month follow-up care of each cohort were summarised and tested for trends over time. Multivariable logistic regression models determined associations between these factors and discharge to care homes.Results: Of 4,879 patients, 452 (10.1%) were discharged to care homes. This proportion decreased from 17.1% in 1995–1999 to 4.2% in 2010–2014. Over time, hospital stays shortened (median: 89–50 days, p<0.001) and stroke unit admissions increased (31.0-92.5%, p<0.001). The total number of 3-months post-stroke prescriptions also increased over time, including for clopidogrel (0.0-25.0%, p<0.001) and statins (1.7-45.0%, p<0.001), as well as physiotherapy(14.8-38.9%, p<0.001). However, over time the proportion of patients with a GCS score <13 has increased (29.1-48.6%, p¼0.005). Compared to patients discharged to their own homes, predictors of discharge to care homes include (odds ratio, 95% confidence interval): hospital stay of >60 days (15.9, 10.2-25.7), old age (5.8, 3.5-9.7), White ethnicity (1.7, 1.2-2.5), GCS <13 (2.0, 1.4-2.8), incontinence (1.8, 1.2-2.5), and a post-stroke BI <15 (3.7, 2.1-6.8).Conclusions: Over time, fewer but more severe stroke survivors are discharged to care homes with improved access to stroke interventions. Further research should investigate whether care homes are well equipped to meet the increasing needs of incoming patients.

U2 - DOI: 10.1177/2396987319845560

DO - DOI: 10.1177/2396987319845560

M3 - Meeting abstract

SN - 2396-9873

VL - 4

SP - 30

EP - 30

JO - European Stroke Journal

JF - European Stroke Journal

IS - 1_suppl

M1 - AS14-014

ER -