Early assessment by a mobile stroke team: a randomised controlled trial.
BACKGROUND
There is overwhelming evidence of the effectiveness of specialist stroke rehabilitation, but more limited evidence of the effectiveness of organised stroke care during the acute phase of stroke.


OBJECTIVE
To determine the impact on outcome of access to a mobile team during the acute phase of stroke among patients admitted to general wards.


METHODS
308 patients admitted to one of two hospitals within 5 days of the onset of a clinically diagnosed stroke.


METHODS
Randomised controlled trial.


METHODS
Following admission, patients in the intervention arm were visited by members of a mobile stroke team who advised clinical staff on appropriate and timely investigation and management. They co-ordinated early input from therapy groups and identified those ready for transfer to the stroke rehabilitation unit. Patients in the control arm were not visited by the mobile stroke team.


METHODS
All-cause mortality measured at 6 weeks and 12 months.


RESULTS
There was no statistically significant difference observed between study groups in mortality at 6 weeks (95% CI(adj) -7.4 to 7.4%) nor at 12 months ( 95% CI(adj) -4.1 to 15.9%). There were also no differences observed between study groups in morbidity outcomes or health-related quality of life measured at 12 months.


CONCLUSIONS
The trial was terminated before the necessary sample size was collected but findings suggest that the mobile stroke team failed to confer significant long-term mortality benefit compared with general ward-based care alone.
Dey
Paola
P
University of Manchester, UK. PaolaDey62@hotmail.com
Woodman
Miriam
M
Gibbs
Alan
A
Steele
Robert
R
Stocks
S Jill
SJ
Wagstaff
Susan
S
Khanna
Veneet
V
Chaudhuri
Mohan Datta
MD
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008952:Mobile Health Units; D010348:Patient Care Team / Q000458:organization & administration*; D020521:Stroke / Q000628:therapy*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome