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Lund Stroke Register: hospitalization pattern and yield of different screening methods for first-ever stroke
B Hallström1, A-C Jönsson, C Nerbrand
1Department of Clinical Sciences, Lund, Neurology, Lund University, Lund, Sweden.
Insights
Hospitalization for first-ever stroke was 84%, with mild stroke cases and elderly nursing home residents often not hospitalized. These groups had distinct outcomes and characteristics.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Stroke case ascertainment and hospitalization patterns are crucial for understanding population health.
- Identifying characteristics of hospitalized versus non-hospitalized stroke patients informs resource allocation and care strategies.
Purpose of the Study:
- To investigate the ascertainment and hospitalization rates of first-ever stroke patients in a defined population.
- To characterize hospitalized and non-hospitalized stroke patient groups.
Main Methods:
- A one-year population-based screening for first-ever strokes was conducted in the Lund-Orup district.
- Multiple prospective and retrospective methods were employed for comprehensive case ascertainment.
Main Results:
- A total of 456 first-ever stroke patients were identified.
- The hospitalization proportion within 14 days was 84%.
- Non-hospitalized patients included those with mild strokes sent home from emergency care (low case-fatality) and elderly nursing home residents (high case-fatality).
Conclusions:
- Hospitalization rates for first-ever stroke were lower than anticipated.
- Key non-hospitalized groups comprised patients with mild strokes and elderly individuals in nursing homes, each with distinct clinical trajectories.
Objectives:
To explore case ascertainment, hospitalization, characteristics of both hospitalized and non-hospitalized patients in a population-based group of stroke patients.
Materials And Methods:
One-year screening in Lund-Orup district for first-ever strokes using multiple prospective and retrospective methods.
Results:
A total of 456 patients with first-ever stroke (n = 412 prospective screening methods, n = 17 primary care, n = 12 hospital registers, n = 10 death register, n = 2 autopsy registers, n = 3 other). Hospitalization proportion within 14 days was 84%. Patients sent home from emergency unit (n = 36) were often males (75%), had low 28-day case-fatality (0%), and less severe strokes (median National Institute of Health Stroke Scale score 2 vs 4 for all). Patients managed solely within primary care (n = 18) were elderly (median age 89 vs 77 years for all), resided in nursing homes (86% vs 8% for all) and had high 28-day-case-fatality (61%).
Conclusions:
Hospitalization was lower than expected. Two main categories of patients were not hospitalized: elderly patients at nursing homes with high case-fatality and patients with mild stroke.
