Is the outpatient management of acute minor stroke feasible and safe?
- Correspondence to Professor L Csiba, Department of Neurology, Debrecen University, Móricz krt 22, Debrecen 4032, Hungary;
- Received 28 December 2012
- Accepted 28 December 2012
- Published Online First 18 January 2013
Paul et al 1 have assessed the clinical outcomes, early hospital admission rates and hospital care costs in clinic referred and hospital referred minor stroke patients in a prospective population based study. They did not find significant differences in the 30 day admission rate in clinic patients compared with the 30 day readmission rate after discharge in hospital treated patients (16/237 vs 9/150).
The 30 day recurrent stroke risk in patients with minor ischaemic stroke was also similar in those discharged from clinic compared with hospital patients (3.8% vs 5.3%; p=0.61). The recurrent stroke risk remained similar in patients treated at the clinic compared with those managed in hospital at 1 year (11.5% vs 12.4%; p=0.86) and at the 5 year follow-up (21.2% vs 20.5%; p=0.84). The cost of outpatient management of minor stroke was substantially lower than that of inpatient care, saving £4800 per patient.
The authors conclude that “rapid assessment and treatment of minor …