| Methods |
Uncontrolled before‐and‐after study. CP started if diagnosis of stroke or TIA and not for terminal patients. CP discontinued if signs resolved <24 hours or if a diagnosis of haemorrhagic stroke or non‐stroke was made. 46/121 patients in CP group were excluded or discontinued but remained in analysis. Data collected at 3 time points ‐ 1989 and 1990 (pre‐CP) and 1991‐2 (post‐CP). Retrospective data collection. |
| Participants |
291 patients with ischaemic stroke ‐ CP group 121, 1989 group 80, 1990 group 90. |
| Interventions |
TREATMENT GROUP: clinical pathway care from June 1991 to May 1992; a 7‐day protocol with specified timed and sequential outcome and intervention for each day after admission; standard admission orders, patient and family education material; specific days for assessments by therapists (e.g. swallowing and nutritional screen on day 1; PT, OT, SALT and social worker on day 2); protocols for use of urinary catheter, DVT prophylaxis, parenteral feeding, and bowel program. CONTROL GROUP: undefined patient care (in 1989 and 1990) before CP implemented. |
| Outcomes |
Mean LOS (days): CP=7.3+/‐5.5 vs 1989=10.9+/‐10.7 vs 1990=9.8+/‐8.5. Mortality on discharge: CP=11/121 vs 1989=4/80 vs 1990=6/90. Discharged home: CP=56/121 vs 1989=34/80 vs 1990=36/90. Institutionalisation: CP=50/121 vs 1989=32/80 vs 1990=47/90. UTI: CP=8/121 vs 1990=16/90. Mean hospital costs ($): CP vs 1990= reduced by 14.6%. PEG insertion: CP=10/121 vs 1990=8/90. |
| Notes |
Acute stroke. No data on patient characteristics. Some results (e.g. mortality, institutionalisation) have to be estimated from bar charts. Some outcomes (e.g. UTI) were compared only between CP and 1990 groups. Intention‐to‐treat analysis. |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Allocation concealment? |
Unclear risk |
D ‐ Not used |
