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Updated: Jul 13, 2026
09:21
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Hospital volume and stroke outcome: does it matter?
G Saposnik1, A Baibergenova, M O'Donnell
1Stroke Program, Department of Clinical Neurological Sciences, London Health Sciences Center, University of Western Ontario, London, ON, Canada. saposnikg@smh.toronto.on.ca
Neurology
|July 20, 2007
Summary
Higher annual hospital stroke admission volumes are linked to reduced patient mortality. This study highlights the importance of hospital volume in stroke care outcomes.
Area of Science:
- Neurology
- Public Health
- Health Services Research
Background:
- Limited understanding of the relationship between annual stroke admission volumes and stroke mortality.
- Previous research explored hospital-outcome relationships for various procedures but not specifically for stroke volume.
Purpose of the Study:
- To investigate the association between facility type, hospital stroke admission volume, and stroke mortality.
- To determine if higher hospital volumes correlate with better stroke patient outcomes.
Main Methods:
- Analysis of ischemic stroke admissions from Canada's national Hospital Morbidity database (HMDB) (April 2003-March 2004).
- Ischemic stroke identified using International Classification of Diseases (ICD-9 and ICD-10) principal diagnosis.
- Multivariable generalized estimating equations used to adjust for demographic factors, provider specialty, facility type, and hospital volume.
Main Results:
- 26,676 ischemic stroke admissions across 606 hospitals were analyzed.
- Seven-day mortality was 7.6%; discharge mortality was 15.6%.
- Patients in high-volume facilities (>100-200 strokes/year) had significantly lower 7-day and discharge mortality compared to low-volume facilities (<50 strokes/year), even after multivariable adjustment.
Conclusions:
- Higher annual hospital stroke volumes are consistently associated with lower stroke mortality.
- Further research is recommended to explore reasons for this association, such as case mix, care organization, or process differences.
- Findings suggest potential benefits of centralizing stroke care in high-volume centers.
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