The Outcome of Stroke at Hospital Discharge in New York City Blacks

Of 527 black patients admitted with new stroke to a municipal general hospital, 311 (59%) were discharged alive. Thirty-nine percent of survivors were independent with minimal or mild deficit. Thirty-two percent were independent with significant neurological deficit. Twenty-two percent were dependent, of whom half went home with special assistance and half to nursing homes. Five percent were transferred to a long-term rehabilitation hospital. These figures are similar to those from other races and settings. Stroke patients used more than 12,400 hospital days per year, at least 11 % of all bed-days on the appropriate services. The average stay was 54 days for survivors, 22 days for fatal cases, and 45 days for all cases. The 28% of survivors who were severely disabled used 51% of all the hospital days, much of that time stable and awaiting transfer to long-term care. Such severely disabled patients comprise much of the growing burden of stroke on a community's resources. Expanding long-term care facilities for stroke patients is a social and economic necessity.