Hospitalization within the first year after stroke: the Dijon stroke registry.
OBJECTIVE
This population-based study aimed to identify unplanned hospitalization within the first year after stroke to determine factors associated with it and consequences on survival.


METHODS
All first-ever acute strokes occurring in Dijon, France, from 2009 to 2011, were prospectively collected from a population-based registry. Demographics and clinical data, including stroke severity measured by the National Institutes of Health Stroke Scale and disability after stroke, were recorded. For each patient, the first unplanned hospitalization that occurred within 1 year after stroke was retrieved by linking data with the national French Hospital Discharge Database. Predictors of hospitalization and survival at 1 year were identified using logistic regression models.


RESULTS
Among the 613 patients recorded, 94 (15.3%) were excluded because of early death. Of the 519 remaining patients, 167 (32.2%) were hospitalized at 1 year. Subsequent hospitalization led to in-hospital death for 16 (9.6%) patients. In multivariable analyses, only a history of hypertension and atrial fibrillation were associated with hospitalization. In stratified analyses, the National Institutes of Health Stroke Scale score was associated with a higher risk of hospitalization (odds ratio, 1.13; 95% confidence interval, 1.03-1.22; P=0.006), whereas only a trend was noted for disability (odds ratio, 2.26; 95% confidence interval, 0.82-6.22; P=0.113) in patients who returned home after the index stroke. Hospitalization was negatively associated with being alive at 1 year (odds ratio, 0.36; 95% confidence interval, 0.19-0.66; P<0.01).


CONCLUSIONS
Stroke survivors are at high risk of hospitalization after the episode, and subsequent admission is associated with poor survival, thus highlighting the need for follow-up interventions after discharge to prevent readmission.
From the Dijon Stroke Registry, EA4184, Department of Neurology, University Hospital and Medical School of Dijon (C.L., J.D., B.D., M.G., Y.B.); and Department of Medical Informatics, Division of Medical Informatics University Hospital, Dijon, Inserm U866 (E.B., C.Q.), University of Burgundy, France.
Claire
C
Lainay
From the Dijon Stroke Registry, EA4184, Department of Neurology, University Hospital and Medical School of Dijon (C.L., J.D., B.D., M.G., Y.B.); and Department of Medical Informatics, Division of Medical Informatics University Hospital, Dijon, Inserm U866 (E.B., C.Q.), University of Burgundy, France.
Eric
E
Benzenine
From the Dijon Stroke Registry, EA4184, Department of Neurology, University Hospital and Medical School of Dijon (C.L., J.D., B.D., M.G., Y.B.); and Department of Medical Informatics, Division of Medical Informatics University Hospital, Dijon, Inserm U866 (E.B., C.Q.), University of Burgundy, France.
Jérôme
J
Durier
From the Dijon Stroke Registry, EA4184, Department of Neurology, University Hospital and Medical School of Dijon (C.L., J.D., B.D., M.G., Y.B.); and Department of Medical Informatics, Division of Medical Informatics University Hospital, Dijon, Inserm U866 (E.B., C.Q.), University of Burgundy, France.
Benoit
B
Daubail
From the Dijon Stroke Registry, EA4184, Department of Neurology, University Hospital and Medical School of Dijon (C.L., J.D., B.D., M.G., Y.B.); and Department of Medical Informatics, Division of Medical Informatics University Hospital, Dijon, Inserm U866 (E.B., C.Q.), University of Burgundy, France.
Maurice
M
Giroud
From the Dijon Stroke Registry, EA4184, Department of Neurology, University Hospital and Medical School of Dijon (C.L., J.D., B.D., M.G., Y.B.); and Department of Medical Informatics, Division of Medical Informatics University Hospital, Dijon, Inserm U866 (E.B., C.Q.), University of Burgundy, France.
Catherine
C
Quantin
From the Dijon Stroke Registry, EA4184, Department of Neurology, University Hospital and Medical School of Dijon (C.L., J.D., B.D., M.G., Y.B.); and Department of Medical Informatics, Division of Medical Informatics University Hospital, Dijon, Inserm U866 (E.B., C.Q.), University of Burgundy, France. ybejot@yahoo.fr.
Yannick
Y
Béjot
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012042:Registries; D013223:Statistics as Topic; D020521:Stroke
acute stroke; epidemiology; mortality; outcome; registry