Background: After a stroke, families require the coordinated assistance of health and social care. Currently there is a lack of comprehensive evaluation and assessment tools to identify discharge needs, and there is separate management of health and social resources, and access to these services is variable between regions. Objective:The main objective of this study was to assess the factors associated with risk of dependency after stroke and propose a suitable instrument for identifying patients at higher risk.Methods: This was a 2-year prospective and community study of a stroke cohort. The primary outcome was recognized dependency. The potential predictors were considered in a multivariate regression and area under curve (AUC) to evaluate its discriminative capacity.Results: Overall, 233 stroke survivors were recruited, 49.8% of whom were women, and the average age was 78.1 6 11.6 years. The total rate of dependency was 31.5 (95% confidence interval [CI] 26.1-37.7) cases/100 person-years. The independent factors associated with dependency outcome were age .80 years (hazard ratio [HR] 2.03, 95% CI 1.32-3.12, P = .001),

Stroke, a leading cause of death and long-term disability, has a considerable social and economic impact. It is imperative to investigate stroke-related costs. The main goal was to conduct a systematic literature review on the described costs associated with stroke care continuum to better understand the evolution of the economic burden and logistic challenges. This research used a systematic review method. We performed a search in PubMed/MEDLINE, ClinicalTrial.gov, Cochrane Reviews, and Google Scholar confined to publications from January 2012 to December 2021. Prices were adjusted using consumer price indices of the countries in the studies in the years the costs were incurred to 2021 Euros using the World Bank and purchasing power parity exchange rate in 2020 from the Organization for Economic Co-operation and Development with the XE Currency Data API. The inclusion criteria were all types of publications, including prospective cost studies, retrospective cost studies, database analyses, mathematical models, surveys, and cost-of-illness (COI) studies. Were excluded studies that (a) were not about stroke, (b) were editorials and commentaries, (c) were irrelevant after screening the title and abstract,(d) grey literature and non-academic studies, (e) reported cost indicators outside the scope of the review, (f) economic evaluations (i.e., cost-effectiveness or cost–benefit analyses); and (g) studies not meeting the population inclusion criteria. There may be risk of bias because the effects are dependent on the persons delivering the intervention. The results were synthetized by PRISMA method. A total of 724 potential abstracts were identified of which 25 articles were pulled for further investigation. The articles were classified into the following categories: 1)stroke primary prevention, 2) expenditures related to acute stroke care, 3) expenditures for post-acute strokes, and 4) global average stroke cost. The measured expenditures varied considerably among these studies with a global average cost from €610-€220,822.45. Given the great variability in the costs in different studies, we can conclude that we need to define a common system for assessing the costs of strokes. Possible limitations are related to clinical choices exposed to decision rules that trigger decisions alerts within stroke events in a clinical setting. This flowchart is based on the guidelines for acute ischemic stroke treatment but may not be applicable to all institutions.

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