Page 771

Karger_ESC London_2013

London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 771 806 Rehabilitation and reorganisation after stroke A ‘7 day service’ for therapies: providing an expanded weekend stroke service S. Gawned1, H. Lindfield2, E.V. Cooke3 St. George’s Healthcare NHS Trust, London, UNITED KINGDOM1, St. George’s Healthcare NHS Trust, London, UNITED KINGDOM2, St. George’s Healthcare NHS Trust, London, UNITED KINGDOM3 Background Stroke patients admitted to hospital at the weekend have a higher risk of death and de-veloping secondary complications than those admitted on a weekday. In 2010 quality statements were introduced aiming to improve stroke care, statement 5 requires patients to be assessed by one member of the specialist rehabilitation team within 24 hours and by all within 72 hours. St George’s Healthcare stroke service provided Monday to Friday therapy and was unable to meet this quality statement. Method 12 week pilot of additional weekend therapy was conducted on the Hyperacute and Acute Stroke Units. The expanded weekend therapy service was staffed by an Occupational Therapist, Physiotherapist, Speech and Language Therapist (Saturday only) and a Therapy Techni-cian. Therapy competencies were developed to ensure the service delivered was safe and effective. Access criteria were developed and three priority groups of patients were identified: new admis-sions; potential discharges; patients requiring early rehabilitation. The benefits of the pilot were evaluated using length of stay, achievement of quality statement 5 on the Stroke Improvement National Audit Programme (SINAP), number of new patient assessments on a Monday and provi-sion of 45 minute rehabilitation sessions. Results Over the 12 pilot weekends 208 stroke patients received intervention from the weekend therapy team, with a quarter being discharged home (19%↑- mean weekend discharges). There was a significant improvement in the delivery of quality statement 5 and a reduction in the number of new patients requiring assessment on a Monday for Occupational Therapy and Physiotherapy. There was a trend towards a reducing length of stay and provision of 45 minute rehabilitation sessions remained unchanged. Conclusion Significant improvements in the quality of stroke care at St George’s Healthcare occurred with the introduction of a weekend therapy service as demonstrated by improved delivery of quality statement 5. A ‘7 day service’ for therapies: providing an expanded weekend stroke service Before Pilot Change SINAP Key Indi-cator 9 August 68% September 99% October 99% ↑ 31% Monday New Pa-tient As-sessments (average) OT PT SALT 10.50 11.25 5.83 OT PT SALT 4.08 3.83 5.40 OT PT SALT ↓ 6.42 ↓ 7.42 ↓ 0.43 Length of Stay M 6-7 2011 4.43 M 1-5 2012 5.63 M 6-7 2012 4.75 M 6-7 2011 M 1-5 2012 ↑ 0.32 ↓ 0.88 Provi-sion of 45 Minute Therapy Sessions OT PT SALT 60% 89% 74% OT PT SALT 60% 90% 78% OT PT SALT « « ↑ 4% 807 Rehabilitation and reorganisation after stroke GLYCAEMIA LEVELS DO NOT ALTER DEVELOPMENT IN UNILATERAL SPATIAL NEGLECT TESTS IN ACUTE PHASE STROKE R. BAZAN1, G.J. LUVIZUTTO2, T.A. MONTEIRO3, G.P. BRAGA4, R.M. THEOTONIO5, L.A.L. RESENDE6 Botucatu Medical School, University Estadual Paulista Júlio de Mesquita Filho - UNESP, Botucatu, BRAZIL1, Botucatu Medical School, University Estadual Paulista Júlio de Mesquita Fil-ho - UNESP, Botucatu, BRAZIL2, Botucatu Medical School, University Estadual Paulista Júlio de Mesquita Filho - UNESP, Botucatu, BRAZIL3, Botucatu Medical School, University Estadual Pau-lista Júlio de Mesquita Filho - UNESP, Botucatu, BRAZIL4, Botucatu Medical School, University Estadual Paulista Júlio de Mesquita Filho - UNESP, Botucatu, BRAZIL5, Botucatu Medical School, University Estadual Paulista Júlio de Mesquita Filho - UNESP, Botucatu, BRAZIL6 Background: Hyperglycaemia (HG) is common in non-diabetic patients during acute phase stroke with poor functional results and increased complications in thrombolysed, however it is not clear if it represents a marker of severity in the cognitive domain, therefore the objective of this study was to evaluate the relationship between development in unilateral spatial neglect (USN) tests and glycaemia level in individuals with acute phase stroke. Methods: Observational study of right hemi-sphere ischemic stroke, confirmed by computerized tomography within 48 hours of ictus, admitted to Botucatu Medical School University Hospital, and excluding haemorrhagic stroke, previous mod-ified Rankin Scale (mRS) ≥1, prior Stroke, pre-existing dementia, or other neurological diseases. In-dependent variable: Hb level (mg/dL); Outcome: USN; Potential confounding factors: Age (years), National Institutes of Health Stroke Scale (NIHSS), mRS after stroke, haemoglobin level (mg/dL), and glycated haemoglobin level (%); Measurement of variables: Demographic and anthropometric variables were obtained from electronic medical records, haemoglobin and glycaemia measurements by laboratory exams, and USN by Line Cancellation Test (LCT), Star Cancelation Test (SCT), and Line Bisection Test (LBT). The sample was non-probabilistic, intentional type; Statistics: The rela-tionship between potential confounding factors and USN by Spearman correlation and Mann-Whit-ney and the relationship between glycaemia and USN by Spearman correlation and partial correla-tions, correcting the effect of confounding variables. Results: Twenty-six individuals were evaluated (66+/-14.7 years; 65.4% male; NIHSS: 5+/-2; and mRS at evaluation moment: 3). There was no ev-idence of a significant relationship between glycaemia and LCT and SCT (Figure 1) and with LBT (Table 1). Conclusion: Glycaemia levels did not alter development in unilateral spatial neglect tests in acute phase stroke.


Karger_ESC London_2013
To see the actual publication please follow the link above