Outcome following stroke.

A community study based on an age-stratified sample of those aged 55 years and older in a northern health district in the United Kingdom has been used to consider the implications for purchasing health-care services for those who have survived a stroke. The study showed that while almost a quarter of those reporting a stroke had made a full recovery, a wide range of impairments and disabilities persisted. Almost half reported needing help at least daily. A logistic regression model to predict this level of dependency found that impairments, disabilities and other factors, such as locality, were also predictive of dependency. A second model predicting mobility handicap (dwelling restricted) was found to have a similar mix of predictors. These results show how purchasers must consider the broad outcome in terms of a continuum of impairment, disability and handicap. The results also show that handicap is a distinct concept that draws together many influences which act upon the individual.