To compare the outcomes of elderly stroke patients managed by a geriatric team using a day hospital facility versus conventional medical management.
Prospective, randomized, stratified trial of 120 patients. Stratification was by Barthel Index score (<=15 or 16-19)
Patients were randomized to inpatient care on a stroke ward under the care of either a neurologist or a geriatric team. Those under the care of neurologists were hospitalized until the attending physician felt that they had reached full rehabilitation potential and they did not receive day hospital rehabilitation follow-up. Patients under the care of the geriatric team were discharged home as soon as the team felt they were able to cope and given follow-up rehabilitation at the day hospital. Patients in both groups received an equivalent number of sessions of physiotherapy and occupational therapy during their hospital stay. Family or community support was arranged when necessary for both treatment groups. Patients received follow-up evaluations at 3 and 6 months.
|Type||Measure||Time Frame||Safety Issue|
|Primary||Functional level (BI); hospital and outpatient services received; general well-being as assessed by a self-rated health scale score of 1 (very poor) to 5 (excellent); problems with sleeping; mood as assessed by Geriatric Depression Scale; and level of satisfaction on a scale of 1 to 4; all assessments made at 3 and 6 months. Costs of treatment of the two groups were also compared.|