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Where and how should elderly stroke patients be treated? A randomized trial
1Department of Neurology, University of Helsinki, Finland.
Stroke
|February 1, 1995
Summary
Neurology care for elderly stroke patients significantly improves functional outcomes and reduces hospital stays compared to general medicine care. This specialized management is also more economical.
Area of Science:
- Geriatric Medicine
- Neurology
- Public Health
Background:
- Elderly stroke patients are at risk of suboptimal care.
- Optimal care pathways for stroke are crucial for this demographic.
Purpose of the Study:
- To evaluate the impact of care by the Department of Medicine versus the Department of Neurology on elderly stroke patient outcomes.
- To assess the 1-year outcomes in a randomized controlled trial comparing stroke care models.
Main Methods:
- A randomized controlled trial involving 243 elderly patients (≥65 years) with acute stroke.
- Patients were randomized to care in either the Department of Medicine or Neurology.
- Outcomes assessed included mortality, hospital stay duration, discharge destination, Barthel Index, and Rankin grades at 1 year.
Main Results:
- No significant differences in mortality (21% in both groups) were observed.
- Neurology care led to shorter hospital stays (24 vs. 40 days) and more frequent direct home discharges (75% vs. 62%).
- Patients under neurology care showed better functional status at 1 year (Barthel Index and Rankin grades).
Conclusions:
- Well-organized management of elderly stroke patients, particularly within neurology, improves outcomes.
- Neurological care for stroke patients is associated with better functional recovery and is more cost-effective.