Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/28349
Title: Denial of Cerebrovascular Events in a National Clinical Quality Registry for Stroke: A Retrospective Cohort Study.
Austin Authors: Barclay, Karen M;Kilkenny, Monique F;Breen, Sibilah J;Ryan, Olivia F;Bagot, Kathleen L;Lannin, Natasha A;Thijs, Vincent N ;Cadilhac, Dominique A
Affiliation: Alfred Health, Melbourne, VIC, Australia
Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
The Florey Institute of Neuroscience and Mental Health
Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
Neurology
Issue Date: 2022
Date: 2021-12-01
Publication information: Journal of Stroke and Cerebrovascular Diseases 2022; 31(2): 106210
Abstract: To investigate cerebrovascular event (CVE) denials reported by registered patients to the Australian Stroke Clinical Registry, and to examine the factors associated with CVE denial. CVE denials reported from January 1, 2017 to June 30, 2018 were followed up with hospitals to verify their discharge diagnosis. CVE denials were compared with all non-CVE denial registrants and a 5% random sub-sample of non-CVE deniers according to patient and clinical characteristics, quality of care indicators and health outcomes. Multilevel, multivariable logistic regression models were used. Factors explored were age, sex, stroke severity, type of stroke, treatment in a stroke unit, length of stay and discharge destination. Level was defined as hospital. Overall, 339/23,830 (<2%) CVE denials were reported during the 18-month period. Hospitals confirmed 117 (61%) of CVE denials as a verified diagnosis of stroke or transient ischaemic attack (TIA). Compared to non-CVE deniers, CVE deniers were younger, had a shorter median length of stay (four days versus one day) and were more likely to be diagnosed with a TIA (64%) compared to the other types of stroke (11% intracerebral haemorrhage; 20% ischaemic; 5% undetermined). Very few patients denied their CVE, with the majority of denials subsequently confirmed as eligible for registry inclusion. Diagnosis of a TIA and shorter length of stay were associated with CVE denial. These findings provide evidence that very few cases are incorrectly entered into a national registry, and highlight the characteristics of those unlikely to accept their clinical diagnosis where further education of diagnosis may be needed.
URI: https://ahro.austin.org.au/austinjspui/handle/1/28349
DOI: 10.1016/j.jstrokecerebrovasdis.2021.106210
Journal: Journal of Stroke and Cerebrovascular Diseases
PubMed URL: 34864608
Type: Journal Article
Subjects: Cerebrovascular event
Data quality
Denial
Registry
Stroke
Transient ischaemic attack
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