Research Paper |
Early assessment by a mobile stroke team: a randomised controlled trial
1 Formerly University of Manchester (contact details below)
2 Formerly Manchester Health Authority, Gateway House, Piccadilly South, Manchester, UK
3 University of Manchester, Centre for Cancer Epidemiology, Kinnaird Road, Manchester M20 4QL, UK
4 Formerly Central Liverpool Primary Care Trust, Hartington Road Family Clinic, Hartington Road, Liverpool L8 0SQ, UK
5 University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PL, UK
6 Stockport NHS Foundation Trust, Stepping Hill Hospital, Poplar Grove, Stockport SK2 7JE, UK
7 North Manchester General Hospital, Pennine Acute Hospitals NHS Trust, Delaunays Road, Crumpsall, Manchester M8 5RB, UK
8 Stockport NHS Foundation Trust, Stepping Hill Hospital, Poplar Grove, Stockport SK2 7JE
Address correspondence to: P. Dey, Bury Primary Care Trust, Inwood House, 5 Castlecroft Road, Bury BL9 0EN, UK. Fax: (+44) 0161 778 2111. Email: PaolaDey62{at}hotmail.com
Abstract
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.
Study population: 308 patients admitted to one of two hospitals within 5 days of the onset of a clinically diagnosed stroke.
Study design: randomised controlled trial.
Study groups: 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.
Main outcome measure: 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% CIadj –7.4 to 7.4%) nor at 12 months ( 95% CIadj –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.
Conclusion: 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.
Keywords: cerebrovascular accident, patient team care, randomised controlled trial, elderly
Received August 27, 2004; Revision received January 4, 2005. accepted in revised form January 4, 2005.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. Bosch, M. J. Faber, J. Cruijsberg, G. E. Voerman, S. Leatherman, R. P. T. M. Grol, M. Hulscher, and M. Wensing Review Article: Effectiveness of Patient Care Teams and the Role of Clinical Expertise and Coordination: A Literature Review Med Care Res Rev, December 1, 2009; 66(6_suppl): 5S - 35S. [Abstract] [PDF]
|
|
|
|
 |
|
 G. Saposnik, J. Fang, M. O'Donnell, V. Hachinski, M. K. Kapral, M. D. Hill, and on behalf of the Investigators of the Registry of Escalating Levels of Access to In-Hospital Care and Stroke Mortality Stroke, September 1, 2008; 39(9): 2522 - 2530. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Govan, P. Langhorne, C. J. Weir, and for the Stroke Unit Trialists Collaboration Does the Prevention of Complications Explain the Survival Benefit of Organized Inpatient (Stroke Unit) Care?: Further Analysis of a Systematic Review Stroke, September 1, 2007; 38(9): 2536 - 2540. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W.-D. Heiss and R. W. Teasel Brain Recovery and Rehabilitation Stroke, February 1, 2006; 37(2): 314 - 316. [Full Text] [PDF]
|
|
|
|
|
|
B. Norrving and R. J. Adams Organized Stroke Care Stroke, February 1, 2006; 37(2): 326 - 328. [Full Text] [PDF]
|
|