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| A third of stroke patients need long-term healthcare support |
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16 June 2006
Dutch investigators have found that a third of stroke survivors require professional healthcare support for 15 years or more after the event.
Dr I. van Wijk (University Medical Centre Utrecht, The Netherlands) and co-workers questioned 468 surviving patients who had previously participated in the Dutch Transient Ischemic Attack Trial or the European Atrial Fibrillation Trial. The investigators report in the Journal of Neurology, Neurosurgery, and Psychiatry that a third of these patients still used professional support for one or more of their daily activities, at an average of 15.6 years after their stroke.
Eighteen percent of patients received therapy, such as physical and speech therapy, 26% required daily living support including nursing and home help, 3% needed psychosocial assistance, and 32% used physical aids including wheelchairs. Patients with moderate-to-severe disability and those who were dependent on others in terms of their activities of daily living (ADL) were the most likely to require long-term use of professional healthcare. In all, 26% of patients were moderately to severely handicapped, and 18% had an inactive lifestyle as a result of their stroke damage.
Multivariate analysis revealed that evidence of infarction on baseline computed tomography scan was strongly associated with disability or ADL dependency, as was the occurrence of a subsequent major stroke. In addition, patients with a comorbidity that affected their mobility, such as rheumatoid arthritis, chronic back pain, or joint replacement, were highly likely to be disabled.
"Since the use of professional care was related with the amount of disability or handicap, irrespective of underlying causes, we conclude there is a need for measuring comorbidity in relation to long-term functional status in future stroke outcome research," the team writes. "The focus on comorbidity in relation to stroke may improve the effective planning and providing of healthcare for those in need."
Reference:
J Neurol Neurosurg Psychiatry 2006; Epub ahead of print.
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