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https://ahro.austin.org.au/austinjspui/handle/1/19287| Title: | Quality of Acute Care and Long-Term Quality of Life and Survival: The Australian Stroke Clinical Registry. | Austin Authors: | Cadilhac, Dominique A;Andrew, Nadine E;Lannin, Natasha A;Middleton, Sandy;Levi, Christopher R;Dewey, Helen M;Grabsch, Brenda;Faux, Steve;Hill, Kelvin;Grimley, Rohan;Wong, Andrew;Sabet, Arman;Butler, Ernest;Bladin, Christopher F;Bates, Timothy R;Groot, Patrick;Castley, Helen;Donnan, Geoffrey A ;Anderson, Craig S | Affiliation: | Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg, Victoria, Australia College of Science, Health and Engineering, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia Occupational Therapy Department, Alfred Health, Prahran, Victoria, Australia Nursing Research Institute, St Vincent's Health Australia, Sydney Australian Catholic University, New South Wales Priority Research Centre for Translational Neurosciences Mental Health Research, University of Newcastle Hunter Research Institute, New South Wales, Australia Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia Faculty of Medicine, The University of New South Wales, Sydney St Vincent's Hospital, Darlinghurst, Australia National Stroke Foundation, Melbourne, Victoria, Australia University of Queensland, Brisbane, Australia Neurology Department, Royal Brisbane and Women's Hospital, Queensland, Australia Neurology Department, Gold Coast Hospital, Queensland, Australia Neurology Department, Peninsula Health, Frankston, Victoria, Australia Swan District Hospital and University of Western Australia, Perth, Australia South West Healthcare, Warrnambool, Victoria, Australia Neurology Department, Royal Hobart Hospital, Hobart, Tasmania, Australia The George Institute for Global Health, The University of Sydney, New South Wales, Australia Neurology Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia |
Issue Date: | Apr-2017 | Date: | 2017-03-03 | Publication information: | Stroke 2017; 48(4): 1026-1032 | Abstract: | Uncertainty exists over whether quality improvement strategies translate into better health-related quality of life (HRQoL) and survival after acute stroke. We aimed to determine the association of best practice recommended interventions and outcomes after stroke. Data are from the Australian Stroke Clinical Registry during 2010 to 2014. Multivariable regression was used to determine associations between 3 interventions: received acute stroke unit (ASU) care and in various combinations with prescribed antihypertensive medication at discharge, provision of a discharge care plan, and outcomes of survival and HRQoL (EuroQoL 5-dimensional questionnaire visual analogue scale) at 180 days, by stroke type. An assessment was also made of outcomes related to the number of processes patients received. There were 17 585 stroke admissions (median age 77 years, 47% female; 81% managed in ASUs; 80% ischemic stroke) from 42 hospitals (77% metropolitan) assessed. Cumulative benefits on outcomes related to the number of care processes received by patients. ASU care was associated with a reduced likelihood of death (hazard ratio, 0.49; 95% confidence interval, 0.43-0.56) and better HRQoL (coefficient, 21.34; 95% confidence interval, 15.50-27.18) within 180 days. For those discharged from hospital, receiving ASU+antihypertensive medication provided greater 180-day survival (hazard ratio, 0.45; 95% confidence interval, 0.38-0.52) compared with ASU care alone (hazard ratio, 0.64; 95% confidence interval, 0.54-0.76). HRQoL gains were greatest for patients with intracerebral hemorrhage who received care bundles involving discharge processes (range of increase, 11%-19%). Patients with stroke who receive best practice recommended hospital care have improved long-term survival and HRQoL. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/19287 | DOI: | 10.1161/STROKEAHA.116.015714 | ORCID: | 0000-0001-8162-682X 0000-0001-6324-3403 |
Journal: | Stroke | PubMed URL: | 28258253 | Type: | Journal Article | Subjects: | hospitals quality of health care quality of life Stroke survival |
| Appears in Collections: | Journal articles |
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