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Early cognitive and emotional outcome after stroke is independent of discharge destination
BACKGROUND AND PURPOSE: Cognitive and emotional problems occur frequently after stroke. Patients with minor stroke are more likely to be discharged home. This paper compares early cognitive and emotional outcomes in patients discharged home after stroke versus patients discharged to inpatient rehabi...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577909/ https://www.ncbi.nlm.nih.gov/pubmed/32583049 http://dx.doi.org/10.1007/s00415-020-09999-7 |
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author | Slenders, Jos P. L. Verberne, Daan P. J. Visser-Meily, Johanna M. A. Van den Berg-Vos, Renske M. Kwa, Vincent I. H. van Heugten, Caroline M. |
author_facet | Slenders, Jos P. L. Verberne, Daan P. J. Visser-Meily, Johanna M. A. Van den Berg-Vos, Renske M. Kwa, Vincent I. H. van Heugten, Caroline M. |
author_sort | Slenders, Jos P. L. |
collection | PubMed |
description | BACKGROUND AND PURPOSE: Cognitive and emotional problems occur frequently after stroke. Patients with minor stroke are more likely to be discharged home. This paper compares early cognitive and emotional outcomes in patients discharged home after stroke versus patients discharged to inpatient rehabilitation, and examines the effect of cognitive and emotional outcomes on long-term participation. METHODS: In this multicenter prospective cohort study, patients with stroke were assessed at two months with the Hospital Anxiety and Depression Scale (HADS), the Checklist for Cognitive and Emotional Consequences following Stroke (CLCE-24) and the Montreal Cognitive Assessment (MoCA). One year post stroke, participation was assessed with the Restriction subscale of the Utrecht Scale for Evaluation of Rehabilitation—Participation (USER-P Restriction). RESULTS: The study included 332 patients. Two months post stroke, anxiety and cognitive problems were equally prevalent among patients discharged home (n = 243; 73%) and patients discharged to inpatient rehabilitation (n = 89; 27%) (HADS-A = 4.8 ± 3.9 versus 4.6 ± 4.0, p = 0.747; MoCA < 26: 66.7% versus 70.8%, p = 0.477; CLCE-cognition = 3.0 ± 2.9 versus 3.3 ± 2.8, p = 0.499). Depressive symptoms were less severe in patients discharged home (HADS-D = 4.3 ± 3.9 versus 5.5 ± 3.8, p = 0.010). In patients discharged home, cognitive complaints were predictive of long-term participation (B = − 2.03; 95% CI − 3.15, − 0.90), while cognitive or emotional outcomes were not predictive in patients discharged to inpatient rehabilitation. CONCLUSIONS: Cognitive and emotional problems at two months post stroke were comparable between patients discharged home and those discharged to inpatient rehabilitation. For patients discharged home, cognitive complaints were predictive of long-term participation. |
format | Online Article Text |
id | pubmed-7577909 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-75779092020-10-27 Early cognitive and emotional outcome after stroke is independent of discharge destination Slenders, Jos P. L. Verberne, Daan P. J. Visser-Meily, Johanna M. A. Van den Berg-Vos, Renske M. Kwa, Vincent I. H. van Heugten, Caroline M. J Neurol Original Communication BACKGROUND AND PURPOSE: Cognitive and emotional problems occur frequently after stroke. Patients with minor stroke are more likely to be discharged home. This paper compares early cognitive and emotional outcomes in patients discharged home after stroke versus patients discharged to inpatient rehabilitation, and examines the effect of cognitive and emotional outcomes on long-term participation. METHODS: In this multicenter prospective cohort study, patients with stroke were assessed at two months with the Hospital Anxiety and Depression Scale (HADS), the Checklist for Cognitive and Emotional Consequences following Stroke (CLCE-24) and the Montreal Cognitive Assessment (MoCA). One year post stroke, participation was assessed with the Restriction subscale of the Utrecht Scale for Evaluation of Rehabilitation—Participation (USER-P Restriction). RESULTS: The study included 332 patients. Two months post stroke, anxiety and cognitive problems were equally prevalent among patients discharged home (n = 243; 73%) and patients discharged to inpatient rehabilitation (n = 89; 27%) (HADS-A = 4.8 ± 3.9 versus 4.6 ± 4.0, p = 0.747; MoCA < 26: 66.7% versus 70.8%, p = 0.477; CLCE-cognition = 3.0 ± 2.9 versus 3.3 ± 2.8, p = 0.499). Depressive symptoms were less severe in patients discharged home (HADS-D = 4.3 ± 3.9 versus 5.5 ± 3.8, p = 0.010). In patients discharged home, cognitive complaints were predictive of long-term participation (B = − 2.03; 95% CI − 3.15, − 0.90), while cognitive or emotional outcomes were not predictive in patients discharged to inpatient rehabilitation. CONCLUSIONS: Cognitive and emotional problems at two months post stroke were comparable between patients discharged home and those discharged to inpatient rehabilitation. For patients discharged home, cognitive complaints were predictive of long-term participation. Springer Berlin Heidelberg 2020-06-24 2020 /pmc/articles/PMC7577909/ /pubmed/32583049 http://dx.doi.org/10.1007/s00415-020-09999-7 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Communication Slenders, Jos P. L. Verberne, Daan P. J. Visser-Meily, Johanna M. A. Van den Berg-Vos, Renske M. Kwa, Vincent I. H. van Heugten, Caroline M. Early cognitive and emotional outcome after stroke is independent of discharge destination |
title | Early cognitive and emotional outcome after stroke is independent of discharge destination |
title_full | Early cognitive and emotional outcome after stroke is independent of discharge destination |
title_fullStr | Early cognitive and emotional outcome after stroke is independent of discharge destination |
title_full_unstemmed | Early cognitive and emotional outcome after stroke is independent of discharge destination |
title_short | Early cognitive and emotional outcome after stroke is independent of discharge destination |
title_sort | early cognitive and emotional outcome after stroke is independent of discharge destination |
topic | Original Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577909/ https://www.ncbi.nlm.nih.gov/pubmed/32583049 http://dx.doi.org/10.1007/s00415-020-09999-7 |
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