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Admission to hospital versus non admission after stroke: Trends and survival using the South London Stroke Register

Research output: Contribution to journalConference paper

Original languageEnglish
Pages (from-to)284-284
Number of pages1
JournalCEREBROVASCULAR DISEASES
Volume37
Publication statusPublished - May 2014

King's Authors

Abstract

Background: To identify trends and differences in survival between patients admitted to hospital versus non admission after first ever stroke.

Methods: Population based stroke register of first in a life time strokes between 1995 and 2012 were examined. Baseline data were collection of socio-demographic factors, stroke subtype, case mix and risk factors before stroke. Survival curves were estimated with Kaplan-Meier methods.

Results: 3464 patients were admitted to hospital for stroke. 458 patients were managed in the community. Patients admitted to hospital were more likely to be younger (P=0.02), have more severe impairments for stroke: coma, dysphagia, incontinence, haemorrhagic stroke (P<0.001) and atrial fibrillation (P=0.001). There was a significant trend for increasing admission across subsequent cohorts, 1995-2000 (83%), 2001-2006 (90%) and 2007-2012 (94%), P<0.001. Median (months) survival was higher for non admission (36 vs. 79), P<0.0001 and case fatality at 90 days was lower for non admission (24% vs. 2.6%), P<0.0001. When survival analysis was stratified according to Barthel ≥ 15 at day 7, there no significant differences in survival curves between both groups in 1995-2000 (P=0.5) or 2001-2006 (P=0.4) but there was a significant trend for higher survival rates for non admission in the 2007-2012 cohort (P=0.02).

Conclusion: There is a significant trend for increasing hospital admission over time. There appears to be a survival advantage in the latter cohort for those patients with lower levels of clinical disability at day 7 who are not admitted which requires further explanation.

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