Trends in baseline patient characteristics during the years 1995-2008: observations from Riks-Stroke, the Swedish Stroke Register.
BACKGROUND
Reported improvements in outcome in stroke patients treated in hospital are often attributed to advances in stroke care. However, secular trends in patient characteristics that are present already on admission to hospital may also contribute to improved outcome.


METHODS
Time trends for baseline data (289,854 stroke admittances) in Riks-Stroke, the Swedish national quality register for stroke care, were analyzed for the years 1995 through 2008. The following data were included: number of strokes for each year, age, sex, risk factors, stroke subtype, stroke severity, functional status and need of external home service before the stroke.


RESULTS
The number of annually reported strokes increased until 2005. The proportion of recurrent strokes decreased from 28.0 to 25.9%. The mean age at first-ever stroke increased in women, but not in men. The proportion of smokers dropped, and the proportion of patients who had treated hypertension increased. The stroke severity decreased in men. The prestroke functional status (walking, dressing, toileting) improved in both sexes over these years. More patients lived alone in 2008 than in 1995, and more had home help service.


CONCLUSIONS
Many baseline parameters in Riks-Stroke have changed over the years. This has consequences for the interpretation of outcome data. Some changes may be due to inclusion bias, others due to alterations in general health, evolution of vascular risk factors or demographics.
Appelros
Peter
P
Department of Neurology, Orebro University Hospital, Orebro, Sweden. peter.appelros@orebroll.se
Jonsson
Fredrik
F
Asplund
Kjell
K
Eriksson
Marie
M
Glader
Eva-Lotta
EL
Asberg
Kerstin Hulter
KH
Norrving
Bo
B
Stegmayr
Birgitta
B
Terént
Andreas
A
D000203:Activities of Daily Living; D017668:Age of Onset; D000368:Aged; D004185:Disability Evaluation; D004813:Epidemiology / Q000639:trends; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data; D006801:Humans; D016018:Least-Squares Analysis; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D020127:Recovery of Function; D012008:Recurrence; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome