22. European Stroke Conference 2000 Acute stroke: treatment concepts for physiotherapists and nurses Community ambulation status is predicted by improvement in balance during stroke rehabili-tation J.Q. Yong1, L.X.M. Lim2, A.W.L. Mun3, S.S. Ong4, Y.J. Liang5, B.P.L. Chan6 National University Hospital, Singapore, SINGAPORE1, National University Hospital, Singa-pore, SINGAPORE2, National University Hospital, Singapore, SINGAPORE3, National University Hospital, Singapore, SINGAPORE4, National University Hospital, Singapore, SINGAPORE5, Na-tional University Hospital, , SINGAPORE6 Background Community reintegration is important in stroke rehabilitation as it enhances quality of life. Abili-ty to ambulate in the community is essential for reintegration. This study aims to investigate which outcome measures determine community ambulation in stroke patients who underwent home thera-py. Methodology We prospectively recruited consecutive stroke patients discharged with home therapy under an early supported discharge (ESD) programme from January to December 2012. Inclusion criteria for home therapy include acute stroke within 3 months, residual mild to moderate disability and availability of a carer. Berg Balance Scale (BBS), Functional Independence Measure (FIM), Clinical Outcome Variable Scale (COVS), Motricity Index (MI) and Modified Rankin Scale (MRS) were assessed pre and post-ESD, and were tested for correlation with the patient mobility status (i.e. home ambulant versus community ambulant) upon ESD completion. Results Fifty patients (mean age 60.4 years old, 19 female) were recruited and initiated ESD at 3 days after discharge and completed home therapy with average duration of 17.57+9.42 days. Number of com-munity ambulant patients increased from 7(14%) pre-ESD to 41(82%) post-ESD. Although all mea-sured functional outcomes showed significant improvement on completion of therapy (p<0.001), BBS was the only statistically significant measure in predicting community ambulation status after adjustments for age, gender, co-morbidities and hospital length of stay (OR=1.241, p=0.042). Aver-age BBS score of community ambulant patient is 53.24+2.41, while home ambulant is 35.35+8.15 at discharge. Conclusions Home-based therapy helps to improve community reintegration in stroke patients, and balance as measured by BBS may be useful in predicting community ambulation. Future research can focus on determining the BBS cut off score for community ambulant stroke patients. 196 © 2013 S. Karger AG, Basel 7. Nurses & AHP‘s Meeting 2001 Acute stroke: clinical patterns and practise including nursing Implementation of a swallowing test as a quality-of-care criterion in stroke management was not associated with reduction in early stroke mortality. Results of the nationwide Danish Stroke Register M. Lehmkuhl1, G. Walløe2, C. Dehlendorff3, T.S. Olsen4 The Stroke Unit, Frederiksberg University Hospital, Frederiksberg, DENMARK1, The Stroke Unit, Frederiksberg University Hospital, Frederiksberg, DENMARK2, Danish Cancer Society Re-search Center, Copenhagen, DENMARK3, The Stroke Unit, Frederiksberg University Hospital, Frederiksberg, DENMARK4 Background: Prevention of aspiration in stroke patients with dysphagia may be lifesaving. In Den-mark performance of a clinical swallowing test in patients with acute stroke on the day of admission was chosen as a quality-of-care criterion in stroke management. We studied the independent associa-tion between early mortality in stroke and timely performance of a direct swallowing test on the day of hospital admission. Methods: The Danish Stroke Registry of all hospitalized stroke patients in Denmark includes 27 411 acute stroke patients in whom a swallowing test (since 2007) was considered clinically relevant. The registry contains data on age, sex, civil status, residence, stroke severity (Scandinavian Stroke Scale (SSS) 0-58), computed tomography, and cardiovascular risk factors. Information on death within 1 week and 1 month were obtained through the Danish Death Registry. Logistic regression modeling was used to study the independent association between timely performance of a swallowing test and death within 1 week and 1 month post stroke. Results: Mean age 72.0 years, 48% women, mean SSS 41.5. Of the 27 411 acute stroke patients in whom a swallowing test was considered clinically relevant the test was timely performed on the day of admission in 23 730 (87%) while not in 3 681 (13%). In the multiple logistic regression analysis adjusting for age, sex, civil status, residence, stroke severity (SSS), computed tomography, and car-diovascular risk factors there was no statistically significant difference in mortality between patients who had or had not a swallowing test on the day of admission: 1-week mortality OR 0.80, CI 0.55- 1.17; 1-month mortality OR 0.85, CI 0.65-1.11. Conclusion: Implementation of a clinical swallowing test as a quality-of-care criterion in stroke management was not associated with reduction of early post-stroke mortality. Precautions to prevent aspiration may have been taken even if the test was not timely performed.
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