Evidence map›Paper›PMID 33472788›Full record

Observational studyBMJ open2021

Effect of stroke early supported discharge on length of hospital stay: analysis from a national stroke registry.

Rebecca J Fisher, Adrian Byrne, Niki Chouliara, Sarah Lewis, Lizz Paley, Alex Hoffman, Anthony Rudd, Thompson Robinson, Peter Langhorne, Marion Walker

Abstract readObservational Study
In one paragraph

Observational study in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Rebecca J FisherDivision of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK rebecca.fisher@nottingham.ac.uk.
Adrian ByrneDivision of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK.ORCID 0000-0003-4887-2572
Niki ChouliaraDivision of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK.
Sarah LewisDivision of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
Lizz PaleyDepartment of Population Health Sciences, King's College London, London, UK.
Alex HoffmanDepartment of Population Health Sciences, King's College London, London, UK.
Anthony RuddDepartment of Population Health Sciences, King's College London, London, UK.
Thompson RobinsonDepartment of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Peter LanghorneInstitute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK.
Marion WalkerDivision of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, UK.

Funding

Department of Health 16/01/17
6 · The paper itself

Abstract

objectiveThe first observational study to investigate the impact of early supported discharge (ESD) on length of hospital stay in real-world conditions.

designUsing historical prospective Sentinel Stroke National Audit Programme (SSNAP) data (1 January 2013-31 December 2016) and multilevel modelling, cross-sectional (2015-2016; 30 791 patients nested within 55 hospitals) and repeated cross-sectional (2013-2014 vs 2015-2016; 49 266 patients nested within 41 hospitals) analyses were undertaken.

settingHospitals were sampled across a large geographical area of England covering the West and East Midlands, the East of England and the North of England.

participantsStroke patients whose data were entered into the SSNAP database by hospital teams.

interventionsReceiving ESD along the patient care pathway. PRIMARY AND SECONDARY OUTCOME MEASURES: Length of hospital stay.

resultsWhen adjusted for important case-mix variables, patients who received ESD on their stroke care pathway spent longer in hospital, compared with those who did not receive ESD. The percentage increase was 15.8% (95% CI 12.3% to 19.4%) for the 2015-2016 cross-sectional analysis and 18.8% (95% CI 13.9% to 24.0%) for the 2013-2014 versus 2015-2016 repeated cross-sectional analysis. On average, the increased length of hospital stay was approximately 1 day.

conclusionsThis study has shown that by comparing ESD and non-ESD patient groups matched for important patient characteristics, receiving ESD resulted in a 1-day increase in length of hospital stay. The large reduction in length of hospital stay overall, since original trials were conducted, may explain why a reduction was not observed. The longer term benefits of accessing ESD need to be investigated further. TRIAL REGISTRATION NUMBER: http://www.isrctn.com/ISRCTN15568163.

Indexed as

Patient DischargeStrokeStroke RehabilitationAgedAged, 80 and overCross-Sectional StudiesEnglandFemaleHumansLength of StayMaleProspective StudiesRegistrieshealth policyrehabilitation medicinestrokestroke medicine

Identifiers

PMID33472788
PMCPMC7818805

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.