title: Discharge home after acute stroke: Differences between older and younger patients.
abstract: OBJECTIVE
  To identify determinants for discharge destination of older (≥ 70 years) and younger (< 70 years) acute stroke patients.
  
  
  METHODS
  Multicentre prospective cohort.
  
  
  METHODS
  A total of 395 patients, within 7 days of clinically evaluated stroke, were included from 6 hospital stroke units.
  
  
  METHODS
  The main outcome measure was discharge destination (home vs clinical rehabilitation). Independent variables were: demographic factors, stroke characteristics, functional impairments and disabilities, cognition, comorbidity, and premorbid social participation. Multivariate logistic regression analysis established the independent strength of the contribution of possible determinants to discharge destination.
  
  
  RESULTS
  Seventy-six percent of younger patients were discharged home, compared with 63% of older patients. Most of the younger patients discharged to clinical rehabilitation (71%) had a spouse, whereas only 40% of the older age group discharged to clinical rehabilitation had a spouse. Multivariate analysis showed that, besides National Institutes of Health Stroke Scale and Barthel Index scores, having a spouse was an important determinant for discharge home in the older age group (adjusted odds ratio 4.77, 95% confidence interval 2.01-11.31), but not in the younger age group.
  
  
  CONCLUSIONS
  The presence of a spouse is an additional important factor determining discharge home in older stroke patients. It is important to monitor and support informal caregivers in order to provide appropriate care for older community-dwelling stroke patients.
authors.affiliation: Zonnehuis Group Vlaardingen, Dillenburg Rehabilitation Center, Vlaardingen, The Netherlands.
authors.forename: Roy D
authors.initials: RD
authors.lastname: Dutrieux
authors.forename: Monica
authors.initials: M
authors.lastname: van Eijk
authors.forename: Marloes L
authors.initials: ML
authors.lastname: van Mierlo
authors.forename: Caroline M
authors.initials: CM
authors.lastname: van Heugten
authors.forename: Johanna M A
authors.initials: JM
authors.lastname: Visser-Meily
authors.forename: Wilco P
authors.initials: WP
authors.lastname: Achterberg
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010351:Patient Discharge; D011446:Prospective Studies; D018454:Spouses / Q000706:statistics & numerical data; D020521:Stroke / Q000453:epidemiology*; D000071939:Stroke Rehabilitation