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THE INFLUENCE OF SEX ON OUTCOMES AFTER INTRAVENOUS THROMBOLYSIS: A QUASI-EXPERIMENTAL STUDY USING THE SOUTH LONDON STROKE REGISTER

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ESOC-2019

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Abstract

Background and Aims: Six-month post-stroke reviews help address unmet needs and can be used to identify the impact of acute care and rehabilitation. Guidelines recommend all patients receive a six-month review. We evaluate which factors determine whether reviews are conducted. Methods: Data from the Sentinel Stroke National Audit Programme (SSNAP) collected from April 2013 to March 2018 were used. Group differences were compared using both bivariate and hierarchical regression analyses. Results: 327,156 stroke survivors were included, median age 76 years [IQR 65-84], 52.2% males, 91% had ischaemic strokes, median time to follow-up 6 months [5-7]. Estimated rate of six months review was 24% (95%CI 23.9-24.2). Patients with six months review were significantly more likely to be between 61-80 years (63% vs 57.7%),white (90.4% vs 87.5%), pre-stroke mRS ≤ 2 (88.5% vs 83.4%), hypertensive (55.5% vs 53.5%), receive thrombolysis (13% v 11%) and attained better key indicators. After adjustment, best predictors for six-month review were receipt of early supported discharge (OR 3.2, 95%CI 2.78-3.67), requiring psychological support during admission (1.18,1.05-1.32), having received thrombolysis (1.13, 1.05-1.21). Discharge to nursing home was the most relevant predictor of missing six-month review (0.63, 0.57-0.69). Conclusions: Six-month post-stroke reviews rates were suboptimal. Inequalities for attendance were identified and indicate that those who do receive a review are not representative of the whole population. This information should be used to inform quality improvement initiatives in stroke care.

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© Copyright 2020 Morressier GmbH.
All rights reserved.