Variations in care and outcome in the first year after stroke: a Western and Central European perspective

TY - JOUR

T1 - Variations in care and outcome in the first year after stroke: a Western and Central European perspective

AU - Wolfe, C D A

AU - Tilling, K

AU - Rudd, A

AU - Giroud, M

AU - Inzitari, D

PY - 2004/12

Y1 - 2004/12

N2 - Background: There are significant variations in the short term patterns of care and outcome after a first stroke in Europe. Objective: To estimate the variation in stroke care and outcome up to 1 year after a stroke in selected European centres. Methods: Hospital based stroke registers were established in 11 hospitals in seven western and central European countries to collect demographic, clinical, and resource use data at the time of first ever stroke during 1993-4. At 3 and 12 months, details of survival, activities of daily living score, and use of services were recorded. Univariate comparisons between centres were made using the x 2 test and stepwise regression was used to identify associations between centre, case mix, therapy provision, and outcomes. Results: Of the 4048 patients registered, 23% were lost to follow up and 38% had died at 1 year. The proportions of survivors who felt they needed assistance at 12 months ranged from 35% in Italy to 77% in UK2. There were comparatively high amounts of therapy provided up to 1 year in UK3, France and Germany 1, mainly at home. At 1 year, social services were still providing support in UK1, UK5 and France, with some support in Germany 1 and family support was provided in France. In multivariate analysis, after adjustment for case mix and receipt of rehabilitation, non-UK centres had improved activities of daily living (p

AB - Background: There are significant variations in the short term patterns of care and outcome after a first stroke in Europe. Objective: To estimate the variation in stroke care and outcome up to 1 year after a stroke in selected European centres. Methods: Hospital based stroke registers were established in 11 hospitals in seven western and central European countries to collect demographic, clinical, and resource use data at the time of first ever stroke during 1993-4. At 3 and 12 months, details of survival, activities of daily living score, and use of services were recorded. Univariate comparisons between centres were made using the x 2 test and stepwise regression was used to identify associations between centre, case mix, therapy provision, and outcomes. Results: Of the 4048 patients registered, 23% were lost to follow up and 38% had died at 1 year. The proportions of survivors who felt they needed assistance at 12 months ranged from 35% in Italy to 77% in UK2. There were comparatively high amounts of therapy provided up to 1 year in UK3, France and Germany 1, mainly at home. At 1 year, social services were still providing support in UK1, UK5 and France, with some support in Germany 1 and family support was provided in France. In multivariate analysis, after adjustment for case mix and receipt of rehabilitation, non-UK centres had improved activities of daily living (p

UR - https://www.scopus.com/pages/publications/10044273264

U2 - 10.1136/jnnp.2004.039438

DO - 10.1136/jnnp.2004.039438

M3 - Article

SN - 1468-330X

VL - 75

SP - 1702

EP - 1706

JO - Journal of Neurology, Neurosurgery and Psychiatry

JF - Journal of Neurology, Neurosurgery and Psychiatry

IS - 12

ER -