{"id":2344,"date":"2021-03-23T00:00:00","date_gmt":"2021-03-23T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/temporal-trends-in-case-fatality-discharge-destination-and-admission-to-long-term-care-after-acute-stroke\/"},"modified":"2023-06-14T19:31:52","modified_gmt":"2023-06-14T23:31:52","slug":"temporal-trends-in-case-fatality-discharge-destination-and-admission-to-long-term-care-after-acute-stroke","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/temporal-trends-in-case-fatality-discharge-destination-and-admission-to-long-term-care-after-acute-stroke\/","title":{"rendered":"Temporal trends in case fatality, discharge destination, and admission to long-term care after acute stroke"},"content":{"rendered":"<p><strong>Objective <\/strong>&#x2014; To determine contemporary trends in case fatality, discharge destination, and admission to long-term care after acute ischemic stroke and intracerebral hemorrhage (ICH) using a large, population-based cohort.<\/p>\n<p><strong>Methods <\/strong>&#x2014; We used linked administrative data to identify all emergency department visits and hospital admissions for first-ever ischemic stroke or ICH in Ontario, Canada from 2003-2017. We calculated crude and age\/sex-standardized risk of death at 30 days and 1 year from stroke onset. We stratified crude trends by stroke type, age, and sex and used the Kendall &#x3c4;-b correlation coefficient to evaluate the significance of trends. We determined trends in discharge home and to rehabilitation, and admission to long-term care at 1 year. We used Cox proportional hazard and logistic regression models to assess whether trends in outcomes persisted after adjustment for baseline factors, estimated stroke severity, and use of life-sustaining care.<\/p>\n<p><strong>Results<\/strong> &#x2014; There were 163,574 people with acute ischemic stroke or ICH across the study period. Between 2003 and 2017, age\/sex-standardized 30-day stroke case fatality decreased from 20.5% to 13.2% (7.3% absolute and 36% relative reduction) while that at 1 year decreased from 32.2% to 22.8% (9.3% absolute and 29% relative reduction). Findings were consistent across age, sex, and stroke type, and after adjustment for comorbid conditions, stroke severity and use of life-sustaining care. There was a reduction in long-term care admission after ischemic stroke, and an increase in discharge home or to rehabilitation for both stroke types.<\/p>\n<p><strong>Conclusion <\/strong>&#x2014; We observed substantial reductions in acute stroke case fatality from 2003-2017 with a concurrent increase in discharge to home or rehabilitation and a decrease in long-term care admissions, suggesting continuous improvements in stroke systems of care.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Objective &#x2014; To determine contemporary trends in case fatality, discharge destination, and admission to long-term care after acute ischemic stroke and intracerebral hemorrhage (ICH) using a large, population-based cohort. Methods &#x2014; We used linked administrative data to identify all emergency department visits and hospital admissions for first-ever ischemic stroke or ICH in Ontario, Canada from [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-2344","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Joundi RA, Smith EE, Yu AYX A, Rashid M, Fang J, Kapral MK. <em>Neurology<\/em>. 2021; 96(16):e2037-47. Epub 2021 Mar 23.","source_url":"https:\/\/doi.org\/10.1212\/WNL.0000000000011791","ices_scientist":[1150,1298,13135],"site":[6733],"research_program":[6742],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"EF470557-9C25-4C11-869E-3E6391ECFFDB","sitecore_item_name":"Temporal-trends-in-case-fatality-discharge-destination-and-admission-to-long-term-care-after","sitecore_field_values":"{\n  \"Title\": \"Temporal trends in case fatality, discharge destination, and admission to long-term care after acute stroke\",\n  \"Short title\": \"Temporal trends in case fatality,\",\n  \"Summary\": \"This study aimed to determine contemporary trends in case fatality, discharge destination, and admission to long-term care after acute ischemic stroke and intracerebral hemorrhage.\",\n  \"Citation\": \"<p>Joundi RA, Smith EE, Yu AYX A, Rashid M, Fang J, Kapral MK. <em>Neurology<\/em>. 2021; 96(16):e2037-47. Epub 2021 Mar 23. DOI: <a href=\"https:\/\/doi.org\/10.1212\/WNL.0000000000011791\" title=\"Opens external link\">https:\/\/doi.org\/10.1212\/WNL.0000000000011791<\/a><\/p>\",\n  \"Abstract\": \"<p><strong>Objective <\/strong>&mdash; To determine contemporary trends in case fatality, discharge destination, and admission to long-term care after acute ischemic stroke and intracerebral hemorrhage (ICH) using a large, population-based cohort.<\/p>n<p><strong>Methods <\/strong>&mdash; We used linked administrative data to identify all emergency department visits and hospital admissions for first-ever ischemic stroke or ICH in Ontario, Canada from 2003-2017. We calculated crude and age\/sex-standardized risk of death at 30 days and 1 year from stroke onset. We stratified crude trends by stroke type, age, and sex and used the Kendall &tau;-b correlation coefficient to evaluate the significance of trends. We determined trends in discharge home and to rehabilitation, and admission to long-term care at 1 year. We used Cox proportional hazard and logistic regression models to assess whether trends in outcomes persisted after adjustment for baseline factors, estimated stroke severity, and use of life-sustaining care.<\/p>n<p><strong>Results<\/strong> &mdash; There were 163,574 people with acute ischemic stroke or ICH across the study period. Between 2003 and 2017, age\/sex-standardized 30-day stroke case fatality decreased from 20.5% to 13.2% (7.3% absolute and 36% relative reduction) while that at 1 year decreased from 32.2% to 22.8% (9.3% absolute and 29% relative reduction). Findings were consistent across age, sex, and stroke type, and after adjustment for comorbid conditions, stroke severity and use of life-sustaining care. There was a reduction in long-term care admission after ischemic stroke, and an increase in discharge home or to rehabilitation for both stroke types.<\/p>n<p><strong>Conclusion <\/strong>&mdash; We observed substantial reductions in acute stroke case fatality from 2003-2017 with a concurrent increase in discharge to home or rehabilitation and a decrease in long-term care admissions, suggesting continuous improvements in stroke systems of care.<\/p>\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{85A20A85-A5DB-4EC9-A9C2-DDBB2DEDBF72}|{57AF234D-1D94-4F54-9C03-2816CC1CF638}|{7C1AA55A-490C-4995-A19D-E7F5C28E0012}\",\n  \"Posted Date\": \"20210323T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2021\/March\/Temporal-trends-in-case-fatality-discharge-destination-and-admission-to-long-term-care-after"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Temporal trends in case fatality, discharge destination, and admission to long-term care after acute stroke<\/title>\n<meta name=\"description\" content=\"Objective &#x2014; 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