Effectiviteit van afspraken binnen de Enschedese stroke-service om patiënten met een beroerte adequaat te verwijzen van de stroke-unit in het ziekenhuis naar een verpleeghuis voor kortdurende reactivering

To assess the efficacy of agreements within the Enschede Stroke Service to refer patients with a stroke from the stroke unit in the hospital to a nursing home for short-term rehabilitation.

Design

Prospective, partly retrospective.

Method

All patients who were referred from the stroke unit at Medisch Spectrum Twente to the CVA Rehabilitation Unit (CRU) in the period 1 July 1999-31 July 2003 were included. Referral took place via an active multidisciplinary approach and specific referral agreements. The primary outcome was the number of patients that could be discharged home after rehabilitation. In addition, we assessed the influence on final discharge destination of age, the Barthel and Rankin scores at the time of admission to the CRU and the medical complications during the period of rehabilitation.

Results

232 patients were included (133 women and 99 men, mean age 76.4 years). Within 3 months, 63 of the patients were discharged home. After 6 months, 82 had returned home. 8 of the patients died within 6 months and 9 had to stay in a nursing home permanently. Of the patient aged 80 years or older, 75 could return home within 6 months. Patients with poor Barthel and Rankin scores and medical complications had a smaller chance of being discharged home.

Conclusion

Effective referral of patients from the stroke unit to a nursing home for short-term rehabilitation is possible. With adequate patient selection, the use of good referral agreements and multidisciplinary consultations, most patients could finally return home.

Ned Tijdschr Geneeskd. 2005;149:2344-9