McGahan L, Noorani H, Teasell R, Skidmore B, Doherty T, Brady B; International Society of Technology Assessment in Health Care. Meeting (19th : 2003 : Canmore, Alta.).
Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 2003; 19: abstract no. 174.
Canadian Coordinating Office for Health Technology Assessment (CCOHTA), 865 Carling Ave, Suite 600, Ottawa, ON K1S 5S8 Canada E-mail: lyndam@ccohta.ca
OBJECTIVES: The clinical effectiveness of rehabilitation in a stroke unit (SU) was compared to a general medical ward (GMW) by systematically reviewing randomized controlled trial (RCT) evidence. METHODS: Databases on DIALOG and other systems were searched for literature published between January 1995 and July 2002. RCTs were identified with a follow-up of at least six months post-randomization. Outcome measures included death, physical dependency, place of stay at follow-up, health related quality of life (QOL) and length of hospital stay. Dichotomous outcomes were expressed as odds ratio (OR) and 95% confidence interval (CI) and continuous variables as weighted mean difference (WMD). RESULTS: Six RCTs, involving a total of 1,709 patients, were reviewed as reported in 13 studies. Compared with GMW care, SU care reduced the odds of death (OR 0.61, 95%CI 0.41-0.91) and increased the odds of living at home (OR 1.42, 95%CI 1.05-1.92) at a median follow-up of two years. While the pooled OR demonstrated a reduction in institutionalized care in SU patients at follow-up (0.94), this did not reach statistical significance (95%CI 0.69-1.27). There was heterogeneity among trials. Based on two trials, there was no indication that SU care improved QOL according to the Nottingham Health Profile. DISCUSSION: Patients receiving organized inpatient care in an SU are more likely to be alive, independent, and living at home two years after a stroke compared to those receiving care in a GMW. Heterogeneity in patient population, differences in interventions, and country of setting must be considered in interpreting these results.
Publication Types:
Keywords:
- Hospital Departments
- Hospitalization
- Humans
- Odds Ratio
- Patients' Rooms
- Physical Therapy Department, Hospital
- Stroke
- psychology
- rehabilitation
- hsrmtgs
Other ID:
UI: 102276092
From Meeting Abstracts