Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/19177
Title: Better outcomes for hospitalized patients with TIA when in stroke units: An observational study.
Authors: Cadilhac, Dominique A;Kim, Joosup;Lannin, Natasha A;Levi, Christopher R;Dewey, Helen M;Hill, Kelvin;Faux, Steven;Andrew, Nadine E;Kilkenny, Monique F;Grimley, Rohan;Thrift, Amanda G;Grabsch, Brenda;Middleton, Sandy;Anderson, Craig S;Donnan, Geoffrey A
Affiliation: Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Victoria, Australia
Central Clinical School, The University of Sydney, New South Wales, Australia
Eastern Health Clinical School, Monash University, Victoria, Australia
Australian Catholic University, New South Wales, Australia
The George Institute for Global Health, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
Stroke Division, Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
La Trobe University, Victoria, Australia
University of Newcastle, New South Wales, Australia
National Stroke Foundation, Victoria, Australia
St Vincent's Health Australia (Sydney), New South Wales, Australia
Sunshine Coast Clinical School, The University of Queensland, Queensland, Australia
Issue Date: 31-May-2016
EDate: 2016-05-04
Citation: Neurology 2016; 86(22): 2042-8
Abstract: To investigate differences in management and outcomes for patients admitted to the hospital with TIA according to care on a stroke unit (SU) or alternate ward setting up to 180 days post event. TIA admissions from 40 hospitals participating in the Australian Stroke Clinical Registry during 2010-2013 were assessed. Propensity score matching was used to assess outcomes by treatment group including Cox proportional hazards regression to compare survival differences and other appropriate multivariable regression models for outcomes including health-related quality of life and readmissions. Among 3,007 patients with TIA (mean age 73 years, 54% male), 1,110 pairs could be matched. Compared to management elsewhere in hospitals, management in an SU was associated with improved cumulative survival at 180 days post event (hazard ratio 0.57, 95% confidence interval 0.35-0.94; p = 0.029), despite not being statistically significant at 90 days (hazard ratio 0.66, 95% confidence interval 0.33-1.31; p = 0.237). Overall, there were no differences for being discharged on antihypertensive medication or with a care plan, and the 90- to 180-day self-reported outcomes between these groups were similar. In subgroup analyses of 461 matched pairs treated in hospitals in one Australian state (Queensland), patients treated in an SU were more often prescribed aspirin within 48 hours (73% vs 62%, p < 0.001) and discharged on antithrombotic medications (84% vs 71%, p < 0.001) than those not treated in an SU. Hospitalized patients with TIA managed in SUs had better survival at 180 days than those treated in alternate wards, potentially through better management, but further research is needed.
URI: http://ahro.austin.org.au/austinjspui/handle/1/19177
DOI: 10.1212/WNL.0000000000002715
ORCID: 0000-0001-8162-682X
0000-0002-3375-287X
0000-0001-8533-4170
PubMed URL: 27164692
Type: Journal Article
Observational Study
Appears in Collections:Journal articles

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