Stroke Patients' Status Post-Acute Phase of Illness. How Is It and How Ought It to Be: Ain Shams University Experience

J Stroke Cerebrovasc Dis. 2019 Dec;28(12):104445. doi: 10.1016/j.jstrokecerebrovasdis.2019.104445. Epub 2019 Oct 15.

Abstract

Background: Stroke is a leading cause of disability worldwide with a great impact on quality of life. Ain Shams University Hospital is a tertiary center for neurology and a pioneer in offering comprehensive stroke service in the region.

Methods: A cross sectional study in which an 8 domains questionnaire was applied to all cerebrovascular stroke patients who were admitted to the stroke unit of the neurology department of Ain Shams University Hospital in the period from January 2016 till May 2017, with the aim to define pitfalls in post discharge.

Results: From our study show that 20% of all patients discharged from acute stroke unit did not have further follow up with any stroke doctor. Moreover, 60% of patients were not seen by a physiotherapist after discharge, including almost half of patients with moderate or severe disability on discharge who are expected to have ongoing care needs. Patients who developed stroke complications were more likely to seek follow up. As expected, continuous follow up was associated with increased adherence to secondary preventive medications.

Conclusions: Patient needs should be assessed before patient discharge and patient and care givers should have clear written information on required follow up with stroke doctors, and arrangements made for receiving adequate rehabilitation post discharge.

Keywords: Stroke; follow up; physiotherapy; rehabilitation; secondary prevention; stroke awareness.

MeSH terms

  • Aged
  • Continuity of Patient Care / standards*
  • Cross-Sectional Studies
  • Disability Evaluation
  • Egypt
  • Female
  • Guideline Adherence / standards
  • Health Status
  • Hospitals, University*
  • Humans
  • Male
  • Middle Aged
  • Patient Discharge / standards*
  • Patient Discharge Summaries / standards*
  • Physical Therapy Modalities / standards
  • Practice Guidelines as Topic / standards
  • Practice Patterns, Physicians' / standards*
  • Prognosis
  • Quality Improvement / standards
  • Quality Indicators, Health Care / standards
  • Secondary Prevention / standards*
  • Stroke / diagnosis
  • Stroke / physiopathology
  • Stroke / therapy*
  • Tertiary Care Centers