Predicting the disability of first-time stroke sufferers at 1 year. 12-month follow-up of a population-based cohort in southeast England.

Taub, N. A.; Wolfe, Charles D.A.; Richardson, Emma V.; Burney, Peter

doi:10.1161/01.str.25.2.352

Cited by 134 publications

(67 citation statements)

References 26 publications

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“…Incontinence is a stiong predictor of poor recovery (Gross, 1998;Taub et al, 1994). For example, the presence of incontinence in first-time stroke survivors under 75 years is the best predictor of severe or moderate disability at three months (Taub et al, 1994).…”

Section: Incontinencementioning

confidence: 99%

“…Continence status has also been found to influence the place of discharge (Patel et al, 2001;Taub et al, 1994) although Gross (2000) did not find a significant relationship between continence status at discharge and discharge destination. Incontinence has been found to contribute to self-reported depression (Brittain, 1998) and dramatically increase the relative risk of death (Nakayama et al, 1997;Anderson et al, 1994).…”

Section: Incontinencementioning

confidence: 99%

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Caregiver strain in spouses of stroke patients

Blake¹,

Lincoln²,

Clarke

2003

Clin Rehabil

107

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Objective: To test the ability of a previously generated logistic regression model to predict caregiver strain from carer mood, negative affectivity and perceived patient functional ability. Design: Postal prospective survey. Setting: Spouses of community-residing patients identified from hospital stroke registers. Method: Spouses were assessed at three and six months after stroke. A previously derived equation was used to make predictions at three months of their level of strain at six months, which were compared with observed outcomes. Measures: Spouses were asked to complete the Caregiver Strain Index (CSI), the General Health Questionnaire (GHQ-12), the Positive and Negative Affectivity Schedule (PANAS) and to assess patients' independence in activities of daily living on the Extended Activities of Daily Living Scale (EADL). Results: Of 409 stroke patients, 276 had an identifiable co-resident spouse and 116 (42%) completed the measures. At three months after stroke, 39 carers (34%) were under significant strain with 40 (35%) under strain at six months. The predictive model using the GHQ-12, PANAS and EADL at three months was 78% accurate in predicting levels of caregiver strain at six months. Conclusion: Carers at risk of later strain could be identified for further followup. Services to provide emotional support to carers might be effective in the reduction of carer strain.

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Section: Incontinencementioning

confidence: 99%

Section: Incontinencementioning

confidence: 99%

Caregiver strain in spouses of stroke patients

Blake¹,

Lincoln²,

Clarke

2003

Clin Rehabil

107

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“…21 For the majority of patients who did not lose consciousness, the study shows significant differences in death and dependency unexplained by case mix in these 12 centers, and the size of the difference is unlikely to be explained by chance, bias, and confounding, as previously explained. This is a real effect, but perhaps we have not controlled for all possible confounding variables.…”

Section: Comparisons Between Centersmentioning

confidence: 52%

“…The level of detail decided on was a balance between those factors known to predict outcome 21 and the feasibility of data collection in 12 centers across Europe in a routine manner. Davenport et al 22 discuss the confounding influence that variations in case mix exert on clinical outcome.…”

Section: Data Collection and Case MIXmentioning

confidence: 99%

Western and Central Europe

2017

Global Report on Trafficking in Persons 2016

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Background and Purpose-There are significant variations in mortality rates from stroke in Europe. A European Union BIOMED Concerted Action was established to assess and determine the reasons for the variations in case fatality and disability after stroke. Methods-Hospital-based stroke registers were established in 12 centers in 7 western and central European countries to collect demographic, clinical, and resource use details at the time of first-ever stroke during 1993-1994. At 3 months, details of survival, activity of daily living score, and use of health services were recorded. Multinomial logistic regression was used to estimate the relationship between centers and outcome (dead, functionally independent, functionally dependent), with adjustment for case mix and resource use variables, and to predict outcomes for the full cohort. This should minimize the bias due to loss to follow-up. Results-A total of 4534 stroke events were registered. The mean age was 71.9 years (SD, 12.53). There were significant differences between centers for all case mix and resource use variables (PϽ0.001). Multinomial logistic regression modeling of outcome indicated that for those patients initially unconscious (588), center was not significantly related to outcome (Pϭ0.427). For those initially conscious, there were wide variations in death and dependency between centers after adjustment for case mix, type of bed, and use of CT scan. The predicted proportion dead at 3 months ranged from 42% (95% CI, 35% to 49%) in one UK center to 19% (95% CI, 14% to 24%) in France. Conclusions-Areas with high mortality rates within western and central Europe have been identified for stroke outcome, and there appears to be opportunity for considerable health gain in certain centers. Adjustment for case mix and health service resource use does not explain these differences in outcome. Although there are true differences in outcome, the aspects of care that need to be altered to improve outcome remain unclear despite detailed data collection. Comparisons of outcome of the same design used in the present study do not allow rational policy decisions to be made.

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“…Despite some methodological weaknesses, the analysis of 78 prospective studies showed a tendency to predict functional independence and improve day-to-day activities after stroke (Kwakkel, et al, 1996;Wade & Hawer, 1987;Taub, et al, 1994;Motto, et al, 1999;Thommessen, et al, 1999;Wyller, et al, 1997;Sveen, et al, 1996). An important factor is the ability to perform everyday activities immediately after the stroke reported by the Barthel index during the first 2 weeks.…”

mentioning

confidence: 99%