Abstract
Background And Aims: Stroke causes high levels of impairment and subsequent long-term disability. The aims of this study were to assess the trends in the prevalence of acute stroke impairments over time and their association with death or disability post-stroke.
Methods: Using data from the South London Stroke Register, we estimated the prevalence of nine acute impairments. We assessed adjusted prevalence by stratifying by demographic characteristics. Multivariable logistic regression models tested the association between these impairments and death or disability (Barthel Index <10) up to 10-years post-stroke.
Results: 6,501 patients had a stroke between 1995 and 2018. The prevalence of all impairments declined during this 24-year period, except dysphasia. Dysphagia declined the greatest from 44.5% in 1995–2000 to 21.6% in 2013–2018 (p<0.001). Upper and lower limb impairments were the most prevalent impairments in 2013–2018 at 60.9 and 53.7% respectively. This reduction in prevalence of impairments over time varied by subgroup: greatest declines were in those <85 years old and those with hemorrhagic, and ischemic stroke of undetermined etiology, according to the TOAST classification. Declines in prevalence were smaller in those 85 years old or with small vessel occlusion. The association between acute impairments and death or disability was strongest up to 1-year post-stroke and weakened over time. At 10-years, only incontinence remained strongly associated with death or disability (odds ratio 2.8, 95% confidence interval 1.1–7.8).
Conclusions: Acute stroke impairments have declined over time, consistent with trends seen in milder strokes over time. Exact reasons for these trends require further exploration.
Methods: Using data from the South London Stroke Register, we estimated the prevalence of nine acute impairments. We assessed adjusted prevalence by stratifying by demographic characteristics. Multivariable logistic regression models tested the association between these impairments and death or disability (Barthel Index <10) up to 10-years post-stroke.
Results: 6,501 patients had a stroke between 1995 and 2018. The prevalence of all impairments declined during this 24-year period, except dysphasia. Dysphagia declined the greatest from 44.5% in 1995–2000 to 21.6% in 2013–2018 (p<0.001). Upper and lower limb impairments were the most prevalent impairments in 2013–2018 at 60.9 and 53.7% respectively. This reduction in prevalence of impairments over time varied by subgroup: greatest declines were in those <85 years old and those with hemorrhagic, and ischemic stroke of undetermined etiology, according to the TOAST classification. Declines in prevalence were smaller in those 85 years old or with small vessel occlusion. The association between acute impairments and death or disability was strongest up to 1-year post-stroke and weakened over time. At 10-years, only incontinence remained strongly associated with death or disability (odds ratio 2.8, 95% confidence interval 1.1–7.8).
Conclusions: Acute stroke impairments have declined over time, consistent with trends seen in milder strokes over time. Exact reasons for these trends require further exploration.
| Original language | English |
|---|---|
| Article number | 00597/#2064 |
| Pages (from-to) | 166-166 |
| Journal | International Journal Of Stroke |
| Volume | 15 |
| Issue number | 1_suppl |
| DOIs | |
| Publication status | Published - 7 Nov 2020 |