Publication Date

2019

Abstract

Background

The quality of care and outcomes for people who experience stroke whilst in hospital for another condition has not been previously studied in Australia.

Aims

To explore differences in long-term outcomes among patients with in-hospital events treated in stroke units (SUs) compared to those managed in other hospital wards.

Methods

Forty-five hospitals participating in the Australian Stroke Clinical Registry between January 2010 and December 2014 contributed data. Survival of all patients with in-hospital stroke to 180 days after stroke and health-related quality of life, using EQ-5D-3L among 73% eligible, were compared using multilevel, multivariable regression models. Models were adjusted for age, sex, index of relative socioeconomic disadvantage, ability to walk, stroke type, transfer from another hospital, and history of stroke.

Results

Among 20,786 stroke events, 1182 (5.1%) occurred in-hospital (median age 77 years, 49% male). Patients with in-hospital stroke treated in SUs died less often within 30 days (Hazard Ratio 0.56; 95% CI 0.39-0.81) than those not admitted to SUs. Survivors reported similar health-related quality of life between 90 and 180 days compared to those treated in other wards (coefficient = 0.01, 95% CI –0.06-0.09, P = .78). Patients managed in SUs more often received recommended management (e.g. swallowing screening).

Conclusion

The benefits of SU care may extend to patients experiencing in-hospital stroke. Validation, including accounting for potential residual confounding factors, is required.

School/Institute

Nursing Research Institute

Document Type

Open Access Journal Article

Access Rights

Open Access

Available for download on Friday, November 13, 2020

Included in

Nursing Commons

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