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Poorer Stroke Survival While In Hospital

Patients who suffer a stroke in hospital are more likely to remain there longer, or die there, than patients who are admitted following a stroke, a British study has found.

A comparison between the two groups found that 60 per cent of patients who suffered a stroke while they were in hospital died, compared with 28 per cent of patients who were admitted after they had a stroke. Inpatients who had a stroke stayed in hospital for an average of 31 days compared with 16 days for the patients who were admitted following a stroke.

Researchers point out that the annual incidence of stroke in the community is about two per 1,000 population, but among hospital inpatients the incidence is 11 per 1,000. There is no study, however, which systematically and simultaneously identified all inpatients experiencing stoke as well as all patients who were admitted with a stroke.

During a 30-month period, 100 inpatients with stroke and 1,274 patients admitted with stroke were identified prospectively and their case notes reviewed. Median ages were 75 for inpatients and 74 for admitted patients. Women comprised 54 per cent of inpatients and 51 per cent of admitted patients.

Researchers found that cardiovascular risk factors were significantly higher in inpatients and a previous stroke or transient ischaemic attack was more common among admitted patients.

Although the inpatients and the admitted patients were similar in terms of age and sex, inpatients stayed in hospital longer, were more likely to die in hospital, and had less well documented risk factors.

"Improving staff awareness on medical and surgical wards regarding the importance of the early identification and documentation of known risk factors for stroke may improve outcome," researchers concluded.

Related Link: British Medical Journal.
BMJ 2000;320:1511-12

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