Key result
Early discharge with home care shows no benefit over conventional hospitalization for 6-month disability or death.
RCT (n=102)
randomly assigned
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This prospective randomized controlled study was designed to compare the treatment efficacy, safety and quality of life of ischemic stroke patients treated with conventional (10-day) hospitalization or short (3-day) hospitalization followed by home care treatment. One hundred and two patients with acute ischemic stroke who arrived within 48 h after symptom onset and met the inclusion criteria were studied. Patients were randomly assigned to either of two groups of treatment. Patients in the 'hospitalization' group were hospitalized for 10 days, whereas those in the 'home care' group were admitted only for the first 3 days and were followed at home under the home care program. The baseline characteristics were similar in the two groups. There was no difference in the number of deaths or dependency defined by the Modified Rankin scale more than or equal to 3 between the two groups at 6 months. The relative risk was 0.85 with a 95% confidence interval between 0.35 and 2.04. There was also no difference in the number of patients who had good outcome (NIHSS between 0 and 2 and Barthel index between 75 and 100) at 6 months. One patient in the home care group died due to massive intracerebral hemorrhage. Seventy-nine percent of patients in the home care group were satisfied with the home treatment program.
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Suwanwela et al. (2002) conducted an RCT in acute ischemic stroke (n=102). Short (3-day) hospitalization followed by home care vs. Conventional (10-day) hospitalization was evaluated on Death or dependency (Modified Rankin scale ≥3) at 6 months (RR 0.85, 95% CI 0.35-2.04). Short (3-day) hospitalization with home care showed no significant difference in death or dependency at 6 months versus conventional 10-day hospitalization.
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