Published online before print August 20, 2009, doi: 10.1161/STROKEAHA.109.556720
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(Stroke. 2009;40:3585.)
© 2009 American Heart Association, Inc.
Original Contributions |
Survival, Hazard Function for a New Event, and Healthcare Utilization Among Stroke Patients 
65 Years
From the Department of Public Health and Caring Sciences (L.O., K.S.), Family Medicine, and Clinical Epidemiology Section, Uppsala University, Uppsala, Sweden; the Centre for Clinical Research (L.O., M.O.-P.), Dalarna, Sweden; and the Department of Health and Community (L.B.), Family Medicine Section, Linköping University, Linköping, Sweden.
Correspondence to Lena Olai, RN, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology Section, Uppsala Science Park, 751 85 Uppsala, Sweden. E-mail lena.olai{at}Ltdalarna.se
Background and Purpose— The natural history of stroke is still incompletely understood. The aim of this study was to present detailed data on survival, recurrence, and all types of healthcare utilization before and after a stroke event in patients with stroke.
Methods— Three hundred ninety stroke survivors constituted the study population. Information on survival data during 5 years of follow-up, all hospital admissions since 1971, all outpatient and primary care consultations, and all municipal social service support during the year before and after the index stroke admission and patient interviews 1 week after discharge were obtained.
Results— The risk of death or a new stroke was high in the early phase after admission but then decreased rapidly during the next few months. Mortality during the first 5 years was influenced by age and functional ability, whereas the risk of stroke recurrence was influenced by number of previous strokes, hypertension diagnosis, and sex. On a day-by-day basis, 35% were dependent on municipal support before and 65% after the stroke. The corresponding proportions in outpatient care were 6% and 10%, and for hospital inpatient care 1% to 2% and 2% to 3%. Of the health care provided, nursing care dominated.
Conclusions— The risk of dying or having a new stroke event decreased sharply during the early postmorbid phase. Healthcare utilization increased after discharge but was still moderate on a day-by-day basis, except for municipal social service support, which was substantial.
Key Words: epidemiology • hazard function • health care utilization • municipal support • recurrence