title: A study of 90-day outcomes for a cohort of patients admitted to an Australian metropolitan acute stroke unit.
abstract: This study investigated patients' 90-day outcomes poststroke following an admission to one Australian metropolitan Acute Stroke Unit (ASU) and examined premorbid risk factors associated with these outcomes. Data from patients consecutively admitted from January 2006 to July 2007 (n = 54) to an acute stroke unit within 48 hours of onset of symptoms were linked with the Quality in Acute Stroke Care research project data and were analyzed to identify associations between premorbid risk factors (atrial fibrillation, hypertension, high cholesterol, smoking and diabetes); demographic, clinical and stroke characteristics; and death, disability (modified Rankin Score ≥ 2), dependency (Barthel Index score ≥ 95) and health status (SF-36) poststroke. Within 90 days, 4 participants had died and 45.5% were classified as dependent. Of the total participants, 56.8% were classified as disabled. The SF-36 mean scores indicated that the cohort had less than optimal physical health (46.7, SD = 9.8) and mental health (46.4, SD = 13.1). Analysis of baseline variables showed that participants with atrial fibrillation were more likely to have a severe stroke (p = 0.037). Patients presenting with intracerebral haemorrhage (p = 0.017) and those with subsequent strokes (p = 0.000) had significantly lower Barthel Index scores. A lower SF-36 physical component score at 90 days was significantly associated with intracerebral haemorrhages (p = 0.018) and subsequent strokes (p = 0.026). Although most patients were alive at 90 days poststroke, there were variable levels of morbidity-associated stroke type, subsequent strokes and premorbid risk factors, particularly atrial fibrillation. The findings provide insight into the 90-day outcomes of patients discharged from an ASU, which may be of use to plan appropriate postdischarge support for this group. In particular, aggressive management of stroke risk factors to prevent recurrent stroke is warranted.
authors.affiliation: Nursing Research Institute, St Vincent's & Mater Health Sydney, NSW, Australia.
authors.forename: Asmara
authors.initials: A
authors.lastname: Jammali-Blasi
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McInnes
authors.forename: Romesh
authors.initials: R
authors.lastname: Markus
authors.forename: Steven
authors.initials: S
authors.lastname: Faux
authors.forename: Grainne
authors.initials: G
authors.lastname: O'Loughlin
authors.forename: Simeon
authors.initials: S
authors.lastname: Dale
authors.forename: Sandy
authors.initials: S
authors.lastname: Middleton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation; D001315:Australia; D015331:Cohort Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011446:Prospective Studies; D011787:Quality of Health Care; D015203:Reproducibility of Results; D012307:Risk Factors; D057566:Self Report; D013223:Statistics as Topic; D020521:Stroke / Q000188:drug therapy / Q000401:mortality; D000071939:Stroke Rehabilitation; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome; D014505:Urban Population