Early supported discharge of patients with acute stroke: a randomized controlled trial.
OBJECTIVE
To evaluate the feasibility and effectiveness of early supported discharge (ESD) following acute stroke.


METHODS
An ESD scheme was compared to conventional rehabilitation in a randomized controlled trial. All patients admitted with acute stroke were considered for inclusion. Eighty-eight (20.2%) were found to be eligible and 82 were randomized either to early supported discharge (n = 42) or conventional rehabilitation (n = 40). The primary outcome measure was the Nottingham Extended Activities of Daily Living Scale. The General Health Questionnaire, the Montgomery Aasberg Depression Rating Scale, mortality, placement and patient and career satisfaction served as secondary outcome measures.


RESULTS
Median length of stay was reduced from 31 days in the conventional hospital rehabilitation group to 22 days in the early supported discharge group (p = 0.09). No differences were found regarding primary outcome. The General Health Questionnaire score showed a significant difference in favour of the early supported discharge group at three months (19.5/24, p = 0.02), but not at six. At six months, the proportion of patients being dead or in institution showed a trend of being higher in the conventional rehabilitation group (OR 3.8, 95% CI 0.8-23).


CONCLUSIONS
Early supported discharge after stroke is feasible and it is possible that it has benefits compared with conventional rehabilitation.
Bautz-Holter
E
E
Department of Physical Medicine and Rehabilitation, Ullevaal Hospital, Oslo, Norway. erik.bautz-holter@ioks.uio.no
Sveen
U
U
Rygh
J
J
Rodgers
H
H
Wyller
T Bruun
TB
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D009664:Norway; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D016037:Single-Blind Method; D000071939:Stroke Rehabilitation