Clinical trial NCT06011720: Transitions of Care for Stroke Patients
Official title: Collaborative Study to Reduce Length of Stay and Improve Transitions of Care for Stroke Patients at Robert Wood Johnson University Hospital & JFK Johnson Rehabilitation Institute
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Stroke
Ischemic Stroke
Intracerebral Hemorrhage
Keywords: Stroke
physiatry
rehabilitation
PM&R consultation
Transient Ischemic Attack
Intracerebral Hemorrhage
Ischemic Stroke
Lead sponsor: Rutgers, The State University of New Jersey
Sponsor class: OTHER
Collaborators: name: JFK Medical Center
First posted: 2023-08-25
Enrollment: 3000
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Stroke patients hospitalized within Robert Wood Johnson University Hospital system for Ischemic Stroke or Intracerebral Hemorrhage within the two time frames, July 1st 2015 - June 30th 2017 and January 1st 2018 - December 31st 2019.

Brief summary: For stroke patients, early initiation of therapy typically yields the best functional outcomes. Rehabilitation of stroke patients immediately after hospitalization minimizes deleterious effects of immobility and facilitates restoration of function. The investigators are testing if coordinated efforts between the medical and rehabilitation disciplines may improve stroke patient's functional recovery and subsequent follow-ups after discharge.

Detailed description: Stroke is the fifth leading cause of mortality, claiming the lives of 133,000 individuals in the United States annually. Approximately one-quarter of the 795,000 annual strokes are recurrent. It is estimated that up to 80% of all strokes can be prevented. Forty percent of stroke survivors sustain moderate functional impairments and 15% to 30% sustain severe disability. Approximately 25% of adult stroke patients are readmitted to the hospital within six to twelve months of their preliminary stroke. Identifying and implementing effective medical and rehabilitation interventions is critical in providing care to stroke patients. The goal is to provide optimal, cost-effective care that: 1) prevents secondary medical complications, readmissions, and recurrent disease, and 2) maximizes patient function physically, cognitively, and socially. JFK Johnson Rehabilitation Institute (JRI) proposes a collaborative study with Robert Wood Johnson University Hospital (RWJUH) that addresses this issue while proving beneficial to stroke patients at both institutions. Streamlining the physiatry consult process will improve access to rehabilitation medicine specialty care for acute patients at RWJUH and help facilitate the transfer of stroke patients to the next most appropriate level of care.

Eligibility criteria: Inclusion Criteria:

* Stroke patients hospitalized within Robert Wood Johnson University Hospital system for Ischemic Stroke or Intracerebral Hemorrhage.

Exclusion Criteria:

* Those not in the Robert Wood Johnson University Hospital system.
* Those with a Subarachnoid Hemorrhage or Transient Ischemic Attack (\< 24 hours).

Primary outcomes:
measure: Length of stay (in hours and days).
timeFrame: Data from 1/1/2018-12/31/2019, collected under updated standard of care compared to baseline data from 7/1/2015-6/30/2017.
Secondary outcomes:
measure: Rehospitalization rate.
timeFrame: Data from 1/1/2018-12/31/2019, collected under updated standard of care compared to baseline data from 7/1/2015-6/30/2017.
measure: Functional independence
timeFrame: Data from 1/1/2018-12/31/2019, collected under updated standard of care compared to baseline data from 7/1/2015-6/30/2017.
measure: Stroke clinic outpatient follow-up.
timeFrame: Data from 1/1/2018-12/31/2019, collected under updated standard of care compared to baseline data from 7/1/2015-6/30/2017.
measure: Pre-specified subanalyses for effect on primary outcome measures.
timeFrame: Data from 1/1/2018-12/31/2019, collected under updated standard of care compared to baseline data from 7/1/2015-6/30/2017.
measure: Pre-specified subanalyses for effect on functional independence.
timeFrame: Data from 1/1/2018-12/31/2019, collected under updated standard of care compared to baseline data from 7/1/2015-6/30/2017.
Other outcomes:
Locations:
city: New Brunswick
country: United States
facility: Rutgers-RWJMS Department of Neurology
state: New Jersey
Study officials:
affiliation: Rutgers, The State University of New Jersey
name: Kiwon Lee, MD
role: PRINCIPAL_INVESTIGATOR
References: