Organized Comprehensive Stroke Center is Associated with Reduced Mortality: Analysis of Consecutive Patients in a Single Hospital.
- Author:
Dae Hyun KIM
1
;
Jae Kwan CHA
;
Hyo Jin BAE
;
Hyun Seok PARK
;
Jae Hyung CHOI
;
Myung Jin KANG
;
Byoung Gwon KIM
;
Jae Taeck HUH
;
Sang Beom KIM
Author Information
1. Department of Neurology, Dong-A University College of Medicine, Busan, Korea. nrcjk65@gmail.com
- Publication Type:Original Article
- Keywords:
Stroke center;
Acute ischemic stroke;
Stroke care organization;
Stroke mortality
- MeSH:
Coronary Artery Disease;
Female;
Holidays;
Humans;
Inpatients;
Logistic Models;
Prospective Studies;
Referral and Consultation;
Stroke
- From:Journal of Stroke
2013;15(1):57-63
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND PURPOSE: Organized inpatient stroke care is one of the most effective therapies for improving patient outcomes. Many stroke centers have been established to meet this need, however, there are limited data on the effectiveness of these organized comprehensive stroke center (CSC) in the real-world setting. Our aim is to determine whether inpatient care following the establishment of CSC lowers mortality of patients with acute ischemic stroke (AIS). METHODS: Based on a prospective stroke registry, we identified AIS patients hospitalized before and after the establishment of a CSC. We observed all-cause mortality within 30 days from time of admission. Logistic regression was used to determine whether the establishment of the CSC affects independently the 30-day all-cause mortality. RESULTS: A total of 3,117 consecutive patients with AIS were admitted within seven days after the onset of the symptoms. Unadjusted 30-day mortality was lower for patients admitted to our hospital after the establishment of the CSC than before (5.9% vs. 8.2%, P=0.012). Advanced age, female gender, previous coronary artery disease, non-smoking, stroke subtype, admission on a holiday, referral from other hospitals, high NIHSS on admission, and admission before the establishment of CSC were associated with increased 30-day stroke case fatality. After adjustment for these factors, stroke inpatient care subsequent to the establishment of the CSC was independently associated with lower 30-day mortality (OR, 0.57; 95% CI, 0.412-0.795). CONCLUSIONS: Patients treated after the establishment of a CSC had lower 30-mortality rates than ever before, even adjusting for the differences in the baseline characteristics. The present study reveals that organized stroke care in a CSC might improve the outcome after AIS.
