|
 Patients treated at smaller hospitals also tended to spend more days
at home after a stroke, the study also found.
“Home-time after stroke varied depending on where patients were
hospitalized and in what type of hospital,” said study leader Emily
O’Brian of Duke University in Durham, North Carolina.
“We also found that hospitals with higher home-time had lower rates
of major adverse cardiovascular events and all-cause mortality,
suggesting that home time could be a marker of care quality,”
O’Brian added by email.
To assess how hospital characteristics influence home-time,
researchers analyzed data on 156,887 patients 65 and older who were
discharged from 989 hospitals across the U.S. from 2007 to 2011.
All of the patients had what’s known as ischemic stroke, which
results from an obstruction in a blood vessel supplying the brain.
Researchers sorted hospitals into four groups from lowest to highest
amounts of home time, when patients avoided a repeat hospitalization
or a stay in nursing home or other care facility.
Over the first three months after discharge, average home time was
62 to 73 days for patients treated at hospitals in the
highest-ranked group, compared with 49 to 58 days with hospitals in
the lowest quartile, researchers report in the journal Stroke.
During the first year after discharge, average home time was 274 to
302 days for hospitals in the highest-ranked group, compared with
243 to 264 days for the lowest quartile.
Overall, patients who spent the least amount of time at home in
those first three months were more likely to be older, female,
black, and have more medical problems in addition to stroke than
people who spent the most time at home.
One limitation of the study is that researchers only had data on
care covered by Medicare, the U.S. health program for the elderly,
which would exclude any time patients spent in nursing homes that
they paid for themselves, the authors note.
Because all of the patients in the study were at least 65, it’s also
possible that the results might not apply to younger stroke
survivors, the authors also point out.
[to top of second column] |
One way patients can help maximize time at home after a stroke is by
starting to research rehabilitation facilities as soon as possible,
said Dr. Daniel Lackland, a researcher at the Medical University of
South Carolina who wasn’t involved in the study.
“This is essential in order to achieve the highest level of
independence and quality of life,” Lackland added by email.
Stroke is an emergency, and patients are typically rushed to the
closest hospital that can treat them because faster care increases
survival odds and minimizes the risk of lasting disabilities.
“Patients are often not in a position to choose their treating
hospital, because their physical location more than anything usually
dictates at what facility they will be cared for,” said Dr. Roland
Faigle, a neurology researcher at Johns Hopkins University School of
Medicine in Baltimore.
“For patients and their families, the number one goal should still
be to attempt to prevent a stroke altogether, i.e. by controlling
stroke risk factors, such as high blood pressure, high cholesterol,
and diabetes, in addition to smoking cessation,” Faigle, who wasn’t
involved in the study, said by email.
“If a stroke is occurring regardless, then the most important thing
is to be aware of the signs and symptoms of a stroke, recognize
stroke as an emergency, and to call 911 immediately when a stroke is
suspected,” Faigle added.
Information about warning signs of stroke can be found on the
website of The American Heart Association/American Stroke
Association: http://bit.ly/1iaoEWG.
SOURCE: http://bit.ly/2czxMK9 Stroke, online September 13, 2016.
[© 2016 Thomson Reuters. All rights
reserved.] Copyright 2016 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
 |
