The palliative care needs of acute stroke patients: a prospective study of hospital admissions

Age Ageing. 2010 Sep;39(5):554-9. doi: 10.1093/ageing/afq077. Epub 2010 Jul 20.


Background: despite a mortality rate of approximately 30% in acute stroke, little is known about the palliative care needs of this group of patients.

Design: prospective study of 191 acute stroke patients admitted to hospital in England. Biographical, medical and stroke-related data were collected. Participants completed the Sheffield Profile for Assessment and Referral to Care (SPARC), a screening tool for referral to specialist palliative care.

Findings: over 50% reported moderate to significant fatigue-related problems. Approximately 50% reported symptom-related problems (e.g. pain) or psychological distress (e.g. anxiety). Approximately 25% had concerns about death or dying, and 66% had concerns about dependence and disability. Over 50% were worried about the impact of stroke on family members. There were significant main effects of dependence (Barthel Index) (F(1,123) = 12.640 P = 0.001) and age (F(4,123) = 3.022 P = 0.020), and a significant three-factor interaction between dependence, age and co-morbidities (F(9,123) = 2.199 P = 0.026) in predicting total SPARC scores.

Conclusions: acute stroke patients have a high prevalence of palliative care needs. Acute stroke services should use the SPARC for needs assessment. Priority for assessment should be given to patients with a score of <15/20 on the Barthel Index, a tool already used in most stroke services.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Anxiety / epidemiology
  • Anxiety / therapy
  • Comorbidity
  • England / epidemiology
  • Fatigue / epidemiology
  • Fatigue / therapy
  • Female
  • Health Services for the Aged / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Needs Assessment / statistics & numerical data*
  • Palliative Care / statistics & numerical data*
  • Prevalence
  • Prospective Studies
  • Referral and Consultation / statistics & numerical data
  • Stress, Psychological / epidemiology
  • Stress, Psychological / therapy
  • Stroke / epidemiology*
  • Stroke / therapy*