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Title: Quality of Care and One-Year Outcomes in Patients with Diabetes Hospitalised for Stroke or TIA: A Linked Registry Study.
Austin Authors: Olaiya, Muideen T;Cadilhac, Dominique A;Kim, Joosup;Thrift, Amanda G;Courten, Barbora de;Andrew, Nadine E;Grimley, Rohan;Anderson, Craig S;Sundararajan, Vijaya;Lannin, Natasha A;Levi, Christopher;Dewey, Helen M;Kilkenny, Monique F
Affiliation: Peninsula Clinical School, Central Clinical School, Monash University, VIC, Australia
Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
Alfred Health, Melbourne, VIC, Australia
The University of Sydney, NSW, Australia
The George Institute for Global Health, Sydney NSW, Australia
The George Institute for Global Health at Peking University Health Science Center, China
Department of Public Health, La Trobe University, Bundoora VIC, Australia
Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
Sunshine Coast Clinical School, School of Medicine, Griffith University, Birtinya, QLD, Australia
University of Newcastle, Newcastle, NSW, Australia
Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
The Florey Institute of Neuroscience and Mental Health
Issue Date: 10-Sep-2021 2021-09-10
Publication information: Journal of Stroke and Cerebrovascular Diseases 2021; 30(11): 106083
Abstract: To evaluate key quality indicators for acute care and one-year outcomes following acute ischaemic stroke (IS), intracerebral haemorrhage (ICH), or transient ischaemic attack (TIA) by diabetes status. Observational cohort study (2009-2013) using linked data from the Australian Stroke Clinical Registry and hospital records. Diabetes was ascertained through review of hospital records. Multilevel regression models were used to evaluate the association between diabetes and outcomes, including discharge destination, and mortality and hospital readmissions within one-year of stroke/TIA. Among 14,132 patients (median age 76 years, 46% female), 22% had diabetes. Compared to patients without diabetes, those with diabetes were equally likely to receive stroke unit care, but were more often discharged on antihypertensive agents (79% vs. 68%) or with a care plan (50% vs. 47%). In patients with TIA, although 86% returned directly home after acute care, those with diabetes more often had a different discharge destination than those without diabetes. Diabetes was associated with greater all-cause mortality (hazard ratio 1.13, 95% CI 1.04-1.23) in patients with IS/ICH; and with both greater all-cause (1.81, CI 1.35-2.43) and CVD mortality (1.75, CI 1.06-2.91) in patients with TIA. Similarly, diabetes was associated with greater rates of all-cause readmission in both patients with IS/ICH and TIA. Despite good adherence to best care standards for acute stroke/TIA, patients with comorbid diabetes had worse outcomes at one-year than those without comorbid diabetes. Associations of diabetes with poorer outcomes were more pronounced in patients with TIA than those with IS/ICH.
DOI: 10.1016/j.jstrokecerebrovasdis.2021.106083
Journal: Journal of Stroke and Cerebrovascular Diseases
PubMed URL: 34517297
Type: Journal Article
Subjects: Diabetes
Appears in Collections:Journal articles

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