Abstract WMP62: Organized Comprehensive Stroke Center Is Associated With Reduced Mortality After Acute Ischemic Stroke
Background and Purpose: Organized inpatient stroke care is one of the most effective therapies to improve patient outcomes. For this purpose, many stroke centers have been established. However, there are limited data on the effectiveness of organized comprehensive stroke center (CSC) in the real-world setting. Our aim is to determine whether inpatients care after the establishment of CSC lowers mortality of patients with acute ischemic stroke (AIS).
Methods: Based on our prospective stroke registry, we identified all patients with AIS within 7 days after the onset of symptoms to our hospital between January 2006 and December 2011. We divided the patients with AIS into two groups according to the hospitalization before and after the establishment of CSC. The outcome of interest was all-cause mortality within 30 days from time of admission. We analyzed 30-day case fatality by means of logistic regression to evaluate whether the establishment of CSC is independently associated with reduced 30-day all-cause mortality.
Results: A total of 3,117 consecutive patients with AIS were admitted within seven days after the onset of the symptoms. Unadjusted 30-day mortality was lower after the establishment than ever before (5.9% vs 8,2%, p=0.012). On the unadjustment analysis, advanced age, female gender, previous coronary artery disease, no current smoking, stroke subtype, admission on holiday, referral from other hospitals, higher NIHSS score on admission, and admission before the establishment of CSC were associated with 30-day stroke case fatality. After the adjustment of these factors, stroke inpatients care after the establishment of CSC was independently associated with lower 30-day mortality (OR, 0.57; 95% CI, 0.412-0.795).
Conclusions: Patients admitted after the establishment of CSC had lower risk-adjusted 30-mortality rates than ever before. The present study has revealed that organized stroke care in CSC could improve the outcome after AIS.
- © 2012 by American Heart Association, Inc.