[The care of patients with cerebral circulatory disorders in the catchment area of one of Warsaw's neurological hospital departments. II. Indications for active ambulatory care of patients discharged from the hospital]. / Opieka nad chorymi z zaburzeniami krazenia mózgowego w obszarze dzialania jednego z warszawskich oddzialów neurologicznych. II. Wskazania do ambulatoryjnej opieki czynnej chorych wypisanych ze szpitala.

In a continuation of the analysis of patients hospitalized for cerebrovascular disease their status upon discharge from the hospital was estimated. It was thought that at least 18% of the admitted patients and about 31% of the discharged patients aged below 80 years were suitable for outpatient rehabilitation treatment after discharge because of motor or speech disturbances, and about 9% of the discharged patients required speech reeducation due to aphasia. Among patients after cerebrovascular episodes qualified after discharge for ambulatory active care because of persistent motor deficit or speech disturbances those with past ischaemic stroke prevailed, they were aged mostly 70-79 years. It may be estimated that at least 7% of patients discharged home after stroke (and about 4% of all admitted cases) require special care and nursing because of coexistence of other serious diseases or previously suffered disability. They are potential candidates for care in welfare homes, and when they remain in their homes they depend on the help and care, in different grades, on the assistance of a nurse or at least an unqualified welfare worker.

[Care of patients with cerebrovascular disorders in the health service area of one of Warsaw's neurological hospital departments. I. Hospital admissions]. / Opieka nad chorymi z zaburzeniami krazenia mózgowego w obszarze dzialania jednego z warszawskich oddzialów neurologicznych. I. Przyjecia do szpitala.

A group of patients hospitalized in the period from Oct 1 1978 to March 31 1980 for cerebrovascular disease was analysed in a Warsaw neurological hospital department. It was estimated that in this time period the annual number of patients admitted with acute and subacute episodes of cerebral circulatory failure was 90 per 100 thousand of the population in the catchment area of the hospital. About one-fifth of all admissions were due to haemorrhagic strokes, in 40% of cases ischaemic stroke was diagnosed, in 16% the character of stroke was unrecognized, 9% had transient brain ischaemia, and 15% had other vascular syndromes. The mean duration of hospital stay of the admitted patients was about 29 days, and that of the discharged patients was 38 days. The mortality was 40%. Differences were found in the index of admissions, pattern of diagnoses and mortality between patients from the catchment area and those from a more distant area, which may suggest a bias in the admissions of cerebrovascular disease cases indicating that the availability of the services of the hospital department depends on organizational factors such as distance of the place of residence from the hospital and connections between inpatient and outpatient health services. It may be estimated that in that time period the department admitted not more than 50-60% of stroke cases from its catchment area, including 60-80% from the city district near the hospital and 30% from a more distant districts.