268 Specialist stroke rehabilitation needs in a tertiary hospital—are needs being met?

Abstract

Abstract Background Stroke specific rehabilitation is essential to recovery and return to independence following acute stroke. With increasing cases and improvements in stroke care rehabilitation needs are rising, placing significant pressures on acute stroke units and acute hospital services. We used a point prevalence study to assess the rehabilitation needs of our stroke service. Methods Patients admitted under the stroke service were identified using the electronic patient admissions system on February 17th, 2023. Data was collected by teams of two healthcare professionals. Data collected: demographics, ward location; most appropriate location of care—Hospital, Community, Rehabilitation Unit; Clinical Frailty Score (CFS); Rehabilitation Complexity Score (RCS); estimated Length of Stay (LoS). Results 53 patients admitted under the stroke service, 60% (32/53) patients were on the stroke unit, 40% (21/53) on an outlier ward, 9% (5/53) in the emergency department. Female 45% (24/53) Male 55% (29/53). Of patients >75 years 67% (22/32) had a CFS > 4. 41% (22/53) had primary rehabilitation needs, 30% (16/53) community, and 28% (15/53) hospital care. 17% (9/53) had an estimated LoS > 3 months of those 55% (5/9) had primary rehabilitation needs that could be in a rehabilitation unit. Average RCS 9.7, average RCS 12.6 for patients with an estimated LoS > 3 months. Conclusion Our study shows that limited access to suitable rehabilitation facilities has a direct impact on the coordination of stroke services in the acute setting. A high proportion of patients were not located on the stroke unit, an intervention shown to reduce mortality and disability. This study highlights the importance of ongoing improvement of rehabilitation services.