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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

A. Bhalla, Y. Wang, A. Rudd, C. Wolfe

Original languageEnglish
Pages (from-to)53-53
Number of pages1
JournalInternational Journal Of Stroke
Volume10
Issue numberSupplement S5
Early online date23 Oct 2015
DOIs
Publication statusPublished - Dec 2015

King's Authors

Abstract

Introduction: Despite recommendations for specialist assessment in hospital for stroke, it is important to explore patient characteristics, trends, process of care and differences in outcome between patients admitted to hospital compared to patients not admitted. Method: Population based stroke register of first in a life time strokes between 1995 and 2012. Baseline data included, stroke subtype, case mix and risk factors before stroke. Survival curves were estimated with Kaplan-Meier methods. Logistic regression was used to determine factors associated with poor outcome (dead and dependency: Barthel Index <15) at 1 year. Results: 3464 patients were admitted to hospital for stroke. 458 (12%) patients were not admitted. Patients admitted to hospital were more likely to be younger (P = 0.01), and have more severe impairments for stroke (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. Swallow assessments and brain imaging were performed more frequently in patients admitted to hospital (P < 0.001). When survival analysis was stratified according to Barthel Index ≥ 15 at day 7, there was a significant trend for higher survival rates in the 2007–2012 period (P = 0.02). Non admission was less likely to be associated with poor 1 year outcome in 2001–2006 (OR: 0.33, range: 0.15 to 0.74) and 2007–12 (OR: 0.15, range: 0.04 to 0.63). Discussion: There is a survival advantage and lower levels of dependency after adjusting for potential confounders such as case mix from 2000 for those patients who are not admitted to hospital which requires further explanation

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