The prognosis of stroke survivors primarily discharged to their homes

Stroke is one of the leading causes for nursing home placement (NHP). We have studied the prognosis and risk factors regarding NHP for stroke patients initially discharged to their homes.

All stroke patients in the municipality of Stavanger, Norway, between January 1, 1996, and March 31, 2004, were included and followed until death or May 31, 2012. Time intervals for NHP and death were compared to an age- and sex-matched, stroke-free control cohort. Logistic regression analysis was used to assess risk factors for NHP.

A total of 452 patients were included. A total of 48 patients (10.6%) were directly placed in a nursing home, while 401 patients (88.7%) were discharged to their homes; 180 patients (44.7%) directly and 221 patients (55.3%) after temporary rehabilitation. Of the patients discharged to their homes, 29.7% needed NHP at a later time point as compared to 19.9% of the controls (P<.001). Logistic regression analysis showed that only age (P<.001) was a risk factor for NHP. Stroke patients discharged home and stroke patients admitted directly to nursing home were significantly younger at time of NHP; stroke patients discharged home died significantly earlier than the controls.

Almost 90% of the stroke patients could be discharged to their homes, but they needed more often NHP in the long run than the stroke-free controls. Stroke patients discharged to their homes were younger at the time of NHP and death indicating that the stroke deficit may contribute to increased morbidity and mortality in this patient group.