FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W1977029693> ?p ?o ?g. }

• W1977029693 abstract "To compare outcomes between stroke patients managed on the stroke unit, on general wards with stroke team support or at home by specialist domiciliary team and to derive prognostic variables that will identify patients most suitable for management by each strategy. To describe organisational aspects of individual strategies of stroke care and to evaluate cost-effectiveness of each strategy and its acceptability to patients, carers and professionals.Prospective single-blind randomised controlled trial undertaken in patients recruited from a community-based stroke register.Suburban district in south-east England.Patients with disabling stroke who could be supported at home.The stroke unit gave 24-hour care provided by specialist multidisciplinary team based on clear guidelines for acute care, prevention of complications, rehabilitation and secondary prevention. The stroke team provided management on general wards with specialist team support. The team undertook stroke assessments and advised ward-based nursing and therapy staff on acute care, secondary prevention and rehabilitation aspects. Domiciliary care involved management at home under the supervision of a GP and stroke specialist with support from specialist team and community services. Support was provided for a maximum of 3 months.The primary measure was death or institutionalisation at 1 year. Secondary measures were dependence, functional abilities, mood, quality of life, resource use, length of hospital stay, and patient, carer and professional satisfaction.Of the 457 patients randomised, 152 patients were allocated to the stroke unit; 152 patients to stroke team and 153 patients to domiciliary stroke care (average age 76 years, 48% women). The groups were well matched for baseline characteristics, stroke type and severity, level of impairment and initial disability. Fifty-one (34%) patients in the domiciliary group were admitted to hospital after randomisation. Mortality and institutionalisation at 1 year were lower on stroke unit compared with stroke team or domiciliary care. Significantly fewer patients on the stroke unit died compared with those managed by the stroke team. The proportion of patients alive without severe disability at 1 year was also significantly higher on the stroke unit compared with stroke team or domiciliary care. These differences were present at 3 and 6 months after stroke. Stroke survivors managed on the stroke unit showed greater improvement on basic activities of daily living compared with other strategies. Achievement of higher levels of function was not influenced by strategy of care. Quality of life at 3 months was significantly better in stroke unit and domiciliary care patients. There was greater dissatisfaction with care on general wards compared with stroke unit or domiciliary care. Poor outcome with domiciliary care and on general wards was associated with Barthel Index <5, incontinence and, on general wards, age over 75 years. The total costs of stroke per patient over the 12-month period were pound 11,450 for stroke unit, pound 9527 for stroke team and pound 6840 for home care. However, the mean costs per day alive for the stroke unit were significantly less than those for the specialist stroke team patients, but no different from domiciliary care patients. Costs for the domiciliary group were significantly less than for those managed by the specialist stroke team on general wards.Stroke units were found to be more effective than a specialist stroke team or specialist domiciliary care in reducing mortality, institutionalisation and dependence after stroke. A role for specialist domiciliary services for acute stroke is not supported by this study. Management of patients with strokes on general medical wards, even with specialist team input, is not supported by this study. The stroke unit intervention was less costly per patient day alive and more effective than the stroke team intervention. The stroke unit was more effective and of equivalent cost when compared to home care. Hence, the stroke unit is a more cost-effective intervention than either stroke team or home care. Further research is needed to understand processes contributing to the reduction in mortality on stroke units and to determine the generalisability of these results and the factors that will influence the implementation of the findings of this study in clinical practice." @default.
• W1977029693 created "2016-06-24" @default.
• W1977029693 creator A5007323180 @default.
• W1977029693 creator A5025249879 @default.
• W1977029693 creator A5046168643 @default.
• W1977029693 creator A5058029271 @default.
• W1977029693 creator A5067337029 @default.
• W1977029693 creator A5071163221 @default.
• W1977029693 date "2005-05-01" @default.
• W1977029693 modified "2023-10-15" @default.
• W1977029693 title "A randomised controlled comparison of alternative strategies in stroke care" @default.
• W1977029693 doi "https://doi.org/10.3310/hta9180" @default.
• W1977029693 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/15890138" @default.
• W1977029693 hasPublicationYear "2005" @default.
• W1977029693 type Work @default.
• W1977029693 sameAs 1977029693 @default.
• W1977029693 citedByCount "64" @default.
• W1977029693 countsByYear W19770296932012 @default.
• W1977029693 countsByYear W19770296932013 @default.
• W1977029693 countsByYear W19770296932014 @default.
• W1977029693 countsByYear W19770296932015 @default.
• W1977029693 countsByYear W19770296932016 @default.
• W1977029693 countsByYear W19770296932017 @default.
• W1977029693 countsByYear W19770296932018 @default.
• W1977029693 countsByYear W19770296932019 @default.
• W1977029693 countsByYear W19770296932020 @default.
• W1977029693 countsByYear W19770296932021 @default.
• W1977029693 countsByYear W19770296932022 @default.
• W1977029693 countsByYear W19770296932023 @default.
• W1977029693 crossrefType "journal-article" @default.
• W1977029693 hasAuthorship W1977029693A5007323180 @default.
• W1977029693 hasAuthorship W1977029693A5025249879 @default.
• W1977029693 hasAuthorship W1977029693A5046168643 @default.
• W1977029693 hasAuthorship W1977029693A5058029271 @default.
• W1977029693 hasAuthorship W1977029693A5067337029 @default.
• W1977029693 hasAuthorship W1977029693A5071163221 @default.
• W1977029693 hasBestOaLocation W19770296931 @default.
• W1977029693 hasConcept C127413603 @default.
• W1977029693 hasConcept C141071460 @default.
• W1977029693 hasConcept C159110408 @default.
• W1977029693 hasConcept C168563851 @default.
• W1977029693 hasConcept C1862650 @default.
• W1977029693 hasConcept C2778818304 @default.
• W1977029693 hasConcept C2779951463 @default.
• W1977029693 hasConcept C2780645631 @default.
• W1977029693 hasConcept C71924100 @default.
• W1977029693 hasConcept C78519656 @default.
• W1977029693 hasConceptScore W1977029693C127413603 @default.
• W1977029693 hasConceptScore W1977029693C141071460 @default.
• W1977029693 hasConceptScore W1977029693C159110408 @default.
• W1977029693 hasConceptScore W1977029693C168563851 @default.
• W1977029693 hasConceptScore W1977029693C1862650 @default.
• W1977029693 hasConceptScore W1977029693C2778818304 @default.
• W1977029693 hasConceptScore W1977029693C2779951463 @default.
• W1977029693 hasConceptScore W1977029693C2780645631 @default.
• W1977029693 hasConceptScore W1977029693C71924100 @default.
• W1977029693 hasConceptScore W1977029693C78519656 @default.
• W1977029693 hasFunder F4320334661 @default.
• W1977029693 hasIssue "18" @default.
• W1977029693 hasLocation W19770296931 @default.
• W1977029693 hasLocation W19770296932 @default.
• W1977029693 hasLocation W19770296933 @default.
• W1977029693 hasOpenAccess W1977029693 @default.
• W1977029693 hasPrimaryLocation W19770296931 @default.
• W1977029693 hasRelatedWork W2012235266 @default.
• W1977029693 hasRelatedWork W2092168028 @default.
• W1977029693 hasRelatedWork W2095287266 @default.
• W1977029693 hasRelatedWork W2101319411 @default.
• W1977029693 hasRelatedWork W3005722021 @default.
• W1977029693 hasRelatedWork W3012797690 @default.
• W1977029693 hasRelatedWork W3032418931 @default.
• W1977029693 hasRelatedWork W3095003771 @default.
• W1977029693 hasRelatedWork W3131012514 @default.
• W1977029693 hasRelatedWork W4321332173 @default.
• W1977029693 hasVolume "9" @default.
• W1977029693 isParatext "false" @default.
• W1977029693 isRetracted "false" @default.
• W1977029693 magId "1977029693" @default.
• W1977029693 workType "article" @default.