Why Admit Stroke Patients to Hospital?

Of 135 patients with a recent hemiparesis who were examined, two-thirds were admitted to hospital within the first two weeks. Features favouring admission were urgency in seeking medical help, rapid achievement of full disability, high level of disability and disturbed consciousness at onset. However, many very disabled patients were not admitted—and equally relevant factors favouring admission were social: living alone or with spouse, rather than with child or daughter-in-law; chief carer being male, over 70 and of social classes 3, 4 or 5. Equal numbers of patients aged over 65 were admitted to medical and geriatric wards in the first two weeks, the main difference being that those presenting more urgently were admitted to medical wards, and those with left hemiplegia or with history of heart disease were more likely to be admitted to geriatric wards. Few complex investigations were carried out. Since the overall reasons for admission were principally the need for nursing care in association with social problems at home, increased domiciliary support and early day-hospital care might well diminish further the number of stroke patients admitted to hospital.