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Admissions, patterns of utilization and disposition of cases of acute stroke in Brisbane hospitals
Insights
This study analyzed over 2600 cerebrovascular disease hospital admissions in 1984. Completed strokes affected 1.8 per 1000 adults, with thrombotic strokes being most common and a 21% in-hospital mortality rate.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Cerebrovascular diseases represent a significant cause of morbidity and mortality.
- Understanding the epidemiology and outcomes of acute cerebrovascular events is crucial for healthcare planning.
Purpose of the Study:
- To investigate the incidence, etiological types, and in-hospital outcomes of cerebrovascular disease admissions.
- To compare the characteristics and outcomes of completed strokes versus transient ischemic attacks.
Main Methods:
- Retrospective analysis of all acute hospital admissions for cerebrovascular disease in 1984.
- Inclusion of patients aged over 25 years with International Classification of Diseases (ICD-9) codes 430-437.
- Categorization of stroke types (thrombotic, embolic, hemorrhagic) and assessment of in-hospital mortality and disposition.
Main Results:
- 1264 completed strokes (1.8/1000) and 644 transient ischemic attacks (1.0/1000) were identified in the >25 population.
- Thrombotic strokes constituted 54% of completed strokes; no significant difference was found between clinical and neuroradiological diagnoses.
- In-hospital mortality for completed strokes was 21%, with 28% discharged home and 43% transferred for rehabilitation. Median length of stay was 11.8 days for strokes vs. 6.2 days for TIAs.
Conclusions:
- Cerebrovascular disease admissions in 1984 showed a significant burden of completed strokes and transient ischemic attacks.
- Thrombotic strokes were the predominant etiological type, and in-hospital outcomes varied significantly based on stroke severity and disposition.
- The findings highlight the need for effective stroke prevention and management strategies.
Abstract:
In a population of slightly-more than one million persons, all cases of acute admission to hospital for cerebrovascular disease during 1984 were studied. Of the 2676 hospital admissions, 91% were of public-hospital patients. Of the 1908 patients who were aged more than 25 years and whose conditions were assigned the International classification of diseases' (ICD-9) codes (430-437) for cerebrovascular accidents, 1264 (1.8 patients per 1000 population of older than 25 years of age) cases were completed strokes, and 644 (1.0 patients per 1000 population of older than 25 years of age) cases were transient ischaemic attacks. There was no significant difference between the specific aetiological types of stroke that were diagnosed neuroradiologically and those that were diagnosed clinically. Among the cases of completed strokes, 54% of cases were thrombotic, 11% of cases were embolic, and 15% of cases were haemorrhagic, while nearly 20% of cases were unclassified. Twenty-one per cent of patients who were admitted to hospital with completed strokes died within two weeks of their admission, 28% of such patients were discharged home, 8% of such patients were transferred to full-maintenance care, and the remaining 43% of such patients were transferred for inpatient rehabilitation. The median length of stay for patients with completed strokes was 11.8 days compared with 6.2 days for patients with transient ischaemic attacks.