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Comprehensive Stroke Centers May Be Associated With Improved Survival in Hemorrhagic Stroke

Journal of the American Heart Association, 2015-05, Vol.4 (5), p.n/a [Peer Reviewed Journal]

2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. ;2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. 2015 ;ISSN: 2047-9980 ;EISSN: 2047-9980 ;DOI: 10.1161/JAHA.114.001448 ;PMID: 25950185

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  • Title:
    Comprehensive Stroke Centers May Be Associated With Improved Survival in Hemorrhagic Stroke
  • Author: McKinney, James S. ; Cheng, Jerry Q. ; Rybinnik, Igor ; Kostis, John B.
  • Subjects: Aged ; Aged, 80 and over ; comprehensive stroke center ; Databases, Factual - statistics & numerical data ; Female ; Hospitalization ; Humans ; intracerebral hemorrhage ; Intracranial Hemorrhages - mortality ; Intracranial Hemorrhages - therapy ; Logistic Models ; Male ; Middle Aged ; New Jersey ; Original Research ; Patient Discharge - statistics & numerical data ; Retrospective Studies ; Stroke - mortality ; Stroke - therapy ; subarachnoid hemorrhage ; Survival Analysis
  • Is Part Of: Journal of the American Heart Association, 2015-05, Vol.4 (5), p.n/a
  • Description: Background Comprehensive stroke centers (CSCs) provide a full spectrum of neurological and neurosurgical services to treat complex stroke patients. CSCs have been shown to improve clinical outcomes and mitigate disparities in ischemic stroke patients. It is believed that CSCs also improve outcomes in hemorrhagic stroke. Methods and Results We used the Myocardial Infarction Data Acquisition System (MIDAS) database, which includes data on patients discharged with a primary diagnosis of intracerebral hemorrhage (ICH; International Classification of Diseases, Ninth Revision [ICD‐9] 431) and subarachnoid hemorrhage (SAH; ICD‐9 430) from all nonfederal acute care hospitals in New Jersey (NJ) between 1996 and 2012. Out‐of‐hospital deaths were assessed by matching MIDAS records with NJ death registration files. The primary outcome variable was 90‐day all‐cause mortality. The primary independent variable was CSC versus primary stroke center (PSC) and nonstroke center (NSC) admission. Multivariate logistic models were used to measure the effects of available covariates. Overall, 36 981 patients were admitted with a primary diagnosis of ICH or SAH during the study period, of which 40% were admitted to a CSC. Patients admitted to CSCs were more likely to have neurosurgical or endovascular interventions than those admitted to a PSC/NSC (18.9% vs. 4.7%; P<0.0001). CSC admission was associated with lower adjusted 90‐day mortality (35.0% vs. 40.3%; odds ratio, 0.93; 95% confidence interval, 0.89 to 0.97) for hemorrhagic stroke. This was particularly true for those admitted with SAH. Conclusions Hemorrhagic stroke patients admitted to CSCs are more likely to receive neurosurgical and endovascular treatments and be alive at 90 days than patients admitted to other hospitals.
  • Publisher: England: John Wiley & Sons, Ltd
  • Language: English
  • Identifier: ISSN: 2047-9980
    EISSN: 2047-9980
    DOI: 10.1161/JAHA.114.001448
    PMID: 25950185
  • Source: Freely Accessible Journals
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    Wiley Blackwell Titles (Open access)
    ROAD: Directory of Open Access Scholarly Resources
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