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Quality of Acute Care and Long-Term Quality of Life and Survival: The Australian Stroke Clinical Registry.
Cadilhac, Dominique A; Andrew, Nadine E; Lannin, Natasha A; Middleton, Sandy; Levi, Christopher R; Dewey, Helen M; Grabsch, Brenda; Faux, Steve; Hill, Kelvin; Grimley, Rohan; Wong, Andrew; Sabet, Arman; Butler, Ernest; Bladin, Christopher F; Bates, Timothy R; Groot, Patrick; Castley, Helen; Donnan, Geoffrey A; Anderson, Craig S.
Afiliación
  • Cadilhac DA; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Andrew NE; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Lannin NA; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Middleton S; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Levi CR; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Dewey HM; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Grabsch B; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Faux S; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Hill K; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Grimley R; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Wong A; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Sabet A; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Butler E; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Bladin CF; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Bates TR; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Groot P; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Castley H; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Donnan GA; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
  • Anderson CS; From the Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia (D.A.C., N.E.A.); Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Victoria, Australia (D.A.C., B.G., C.F.B., G.A.D.); College of Sc
Stroke ; 48(4): 1026-1032, 2017 04.
Article en En | MEDLINE | ID: mdl-28258253
ABSTRACT
BACKGROUND AND

PURPOSE:

Uncertainty exists over whether quality improvement strategies translate into better health-related quality of life (HRQoL) and survival after acute stroke. We aimed to determine the association of best practice recommended interventions and outcomes after stroke.

METHODS:

Data are from the Australian Stroke Clinical Registry during 2010 to 2014. Multivariable regression was used to determine associations between 3

interventions:

received acute stroke unit (ASU) care and in various combinations with prescribed antihypertensive medication at discharge, provision of a discharge care plan, and outcomes of survival and HRQoL (EuroQoL 5-dimensional questionnaire visual analogue scale) at 180 days, by stroke type. An assessment was also made of outcomes related to the number of processes patients received.

RESULTS:

There were 17 585 stroke admissions (median age 77 years, 47% female; 81% managed in ASUs; 80% ischemic stroke) from 42 hospitals (77% metropolitan) assessed. Cumulative benefits on outcomes related to the number of care processes received by patients. ASU care was associated with a reduced likelihood of death (hazard ratio, 0.49; 95% confidence interval, 0.43-0.56) and better HRQoL (coefficient, 21.34; 95% confidence interval, 15.50-27.18) within 180 days. For those discharged from hospital, receiving ASU+antihypertensive medication provided greater 180-day survival (hazard ratio, 0.45; 95% confidence interval, 0.38-0.52) compared with ASU care alone (hazard ratio, 0.64; 95% confidence interval, 0.54-0.76). HRQoL gains were greatest for patients with intracerebral hemorrhage who received care bundles involving discharge processes (range of increase, 11%-19%).

CONCLUSIONS:

Patients with stroke who receive best practice recommended hospital care have improved long-term survival and HRQoL.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Alta del Paciente / Calidad de Vida / Sistema de Registros / Evaluación de Resultado en la Atención de Salud / Guías de Práctica Clínica como Asunto / Indicadores de Calidad de la Atención de Salud / Accidente Cerebrovascular / Cuidados Críticos Tipo de estudio: Guideline Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Oceania Idioma: En Revista: Stroke Año: 2017 Tipo del documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Alta del Paciente / Calidad de Vida / Sistema de Registros / Evaluación de Resultado en la Atención de Salud / Guías de Práctica Clínica como Asunto / Indicadores de Calidad de la Atención de Salud / Accidente Cerebrovascular / Cuidados Críticos Tipo de estudio: Guideline Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Oceania Idioma: En Revista: Stroke Año: 2017 Tipo del documento: Article