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Table of Contents
Vol. 25, No. 1-2, 2008
Issue release date: February 2008
Section title: Original Paper
Cerebrovasc Dis 2008;25:12–20
(DOI:10.1159/000111494)

In-Hospital Stroke in a Statewide Stroke Registry

Farooq M.U. · Reeves M.J. · Gargano J. · Wehner S. · Hickenbottom S. · Majid A.
aDepartment of Epidemiology, and bDepartment of Neurology and Ophthalmology, Michigan State University, East Lansing, Mich., and cDepartment of Internal Medicine, Neurology Section, St. Joseph Hospital, Ann Arbor, Mich., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 4/23/2007
Accepted: 7/5/2007
Published online: 11/22/2007
Issue release date: February 2008

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 4

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: http://www.karger.com/CED

Abstract

Background:In-hospital stroke (IHS) represents 5–15% of all hospitalized acute stroke cases, and is associated with poor outcomes. IHS represents an important area for prevention since many cases occur in high-risk patients undergoing cardiovascular procedures. Our objectives were to compare the quality of care, treatments, and outcomes of IHS with out-of-hospital stroke (OHS) cases. Methods: A 6-month prospective cohort of IHS and OHS stroke cases from a statewide acute stroke registry of 15 representative hospitals was assembled. Data were abstracted on demographic, clinical characteristics, in-hospital care (including tPA treatment), discharge instructions, and in-hospital outcomes (mortality and modified Rankin Scale [mRS] at discharge). Results:177 (6.5%) of the 2,743 cases in the registry were IHS cases. 40% of IHS cases were admitted with a cardiovascular or neurologically related problem, and 68% underwent an invasive diagnostic or surgical procedure prior to their stroke. IHS cases were less likely to have the cerebral vasculature examined or to have a lipid panel drawn. Compared to OHS, IHS had higher case fatality (14.6 vs. 6.9%; p = 0.04), greater functional impairment (mRS ≧4) (61 vs. 36%; p < 0.001), and were less likely to be discharged home (23 vs. 52%, p < 0.01). Conclusions:In this prospective registry, 1 in 15 acute stroke cases occurred in the hospital, and almost 70% had an invasive procedure undertaken prior to their stroke event. In-hospital cases received similar quality of care as OHS cases, but had significantly worse outcomes.


  

Author Contacts

Mathew Reeves, PhD
Department of Epidemiology, Michigan State University
B601 West Fee Hall
East Lansing, MI 48824 (USA)
Tel. +1 517 353 8623, Fax +1 517 432 1130, E-Mail reevesm@msu.edu

  

Article Information

Received: April 23, 2007
Accepted: July 5, 2007
Published online: November 22, 2007
Number of Print Pages : 9
Number of Figures : 3, Number of Tables : 4, Number of References : 37

  

Publication Details

Cerebrovascular Diseases

Vol. 25, No. 1-2, Year 2008 (Cover Date: February 2008)

Journal Editor: Hennerici, M.G. (Mannheim)
ISSN: 1015–9770 (Print), eISSN: 1421–9786 (Online)

For additional information: http://www.karger.com/CED


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 4/23/2007
Accepted: 7/5/2007
Published online: 11/22/2007
Issue release date: February 2008

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 4

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: http://www.karger.com/CED


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