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. 2016 Apr 28;6(5):e00455.
doi: 10.1002/brb3.455. eCollection 2016 May.

The stroke east Saxony pilot project for organized post-stroke care: a case-control study

Ulf Bodechtel  1 , Kristian Barlinn  1 , Uwe Helbig  1 , Katrin Arnold  2 , Timo Siepmann  1 , Lars-Peder Pallesen  1 , Volker Puetz  1 , Heinz Reichmann  1 , Jochen Schmitt  2 , Jessica Kepplinger  3
Affiliations

The stroke east Saxony pilot project for organized post-stroke care: a case-control study

Ulf Bodechtel et al. Brain Behav. .

Abstract

Background: Low adherence to secondary prevention guidelines in stroke survivors may increase the risk for recurrent stroke and adversely impact quality of life. We aimed to determine the feasibility of a self-developed standardized post-stroke pathway and its impact on secondary stroke prevention and long-term outcome in patients with acute stroke.

Methods: Consecutive patients with acute stroke were prospectively included in a standardized post-stroke pathway accomplished through a single certified CM (case manager), which comprised educational discussions and quarterly checkups for vascular risk factors and adherence to antithrombotic/anticoagulant medication in addition to usual care. At 12 months, we compared achieved target goals for secondary prevention, functional outcome, stroke recurrence, and vascular death with age- and gender-matched controls that received only usual care after stroke.

Results: We included 45 cases and 45 controls. The following target goals were more frequently achieved in CM-patients than in controls: blood pressure (100% vs. 46.2%, P < 0.001), cholesterol (100% vs. 74.4%, P < 0.001), and body mass index (67.4% vs. 46.2%, P = 0.052). The CM-intervention emerged as an independent predictor of favorable functional outcome (mRS ≤ 2) at 12 months after adjusting for stroke severity and systemic thrombolysis (OR: 4.27; 95%CI:1.2-15.21; P = 0.025). Quality of life was rated significantly higher in CM-patients than in controls (P = 0.049). As opposed to controls, none of the cases experienced a recurrent stroke (0% vs. 13.3%; P = 0.026) or suffered from vascular death (0% vs. 6.7%; P = 0.242).

Conclusions: Our pilot data suggest that organized post-stroke care enhances achievement of secondary prevention goals. Its possible effect on stroke recurrence, long-term disability, and quality of life is currently investigated in a prospective cohort study.

Keywords: Post‐stroke program; secondary stroke prevention.

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Figures

Figure 1
Figure 1
(A) Predefined risk factor goals. BMI indicates body mass index. (B) Study flowchart.
See this image and copyright information in PMC

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