Improving the one-year mortality of stroke patients

An 18-year observation in a teaching hospital

Hua Fen Chen, Chung-Yi Li, Siu Pak Lee, Yam Ting Kwok, Yiu Tong Chu

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Long-term follow-up and comparison of serial changes in the one-year mortality after stroke are important in assessing the quality of stroke management. This study determined the one-year survival rate and prognostic factors of hospitalized hemorrhagic and ischemic stroke patients from 1991 to 2008 in a teaching hospital in Taiwan. We also evaluated the improvements in the one-year mortality after stroke during an 18-year study period. Patients admitted for cerebral hemorrhage (n = 3,678) and cerebral infarction (n = 16,010), identified from an in-patient electronic database, were linked to the National Death Registry of Taiwan. Actuarial analysis was used to determine the one-year survival rates, and Cox proportional hazard regression model was used to investigate the predictors for the one-year mortality of stroke patients. For patients with cerebral hemorrhage and infarction and who were admitted from 1991 to 2008, the one-year survival rates were 71% and 84%, respectively. In addition, stroke patients who also suffered from myocardial infarction, chronic renal illness, and pneumonia and had high Charlson comorbidity index scores showed increased risks of mortality due to cerebral hemorrhage and infarction. Compared with the patients admitted from 1991 to 1996, those admitted from 1997 to 2002 and from 2003 to 2008 showed 15%-20% and 20%-25% reduction in one-year mortality risk in cerebral hemorrhage and infarction, respectively. This result demonstrates the continuous quality improvement of stroke management in the hospital from 1991 to 2008. Further reduction in one-year mortality can be achieved by early recognition and prompt treatment of certain comorbidities.

Original languageEnglish
Pages (from-to)47-54
Number of pages8
JournalTohoku Journal of Experimental Medicine
Volume232
Issue number1
DOIs
Publication statusPublished - 2014 Feb 13

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Teaching Hospitals
Teaching
Stroke
Observation
Cerebral Infarction
Cerebral Hemorrhage
Mortality
Hazards
Survival Rate
Taiwan
Comorbidity
Actuarial Analysis
Quality Improvement
Proportional Hazards Models
Registries
Pneumonia
Chronic Disease
Myocardial Infarction
Databases
Kidney

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Chen, Hua Fen ; Li, Chung-Yi ; Lee, Siu Pak ; Kwok, Yam Ting ; Chu, Yiu Tong. / Improving the one-year mortality of stroke patients : An 18-year observation in a teaching hospital. In: Tohoku Journal of Experimental Medicine. 2014 ; Vol. 232, No. 1. pp. 47-54.
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abstract = "Long-term follow-up and comparison of serial changes in the one-year mortality after stroke are important in assessing the quality of stroke management. This study determined the one-year survival rate and prognostic factors of hospitalized hemorrhagic and ischemic stroke patients from 1991 to 2008 in a teaching hospital in Taiwan. We also evaluated the improvements in the one-year mortality after stroke during an 18-year study period. Patients admitted for cerebral hemorrhage (n = 3,678) and cerebral infarction (n = 16,010), identified from an in-patient electronic database, were linked to the National Death Registry of Taiwan. Actuarial analysis was used to determine the one-year survival rates, and Cox proportional hazard regression model was used to investigate the predictors for the one-year mortality of stroke patients. For patients with cerebral hemorrhage and infarction and who were admitted from 1991 to 2008, the one-year survival rates were 71{\%} and 84{\%}, respectively. In addition, stroke patients who also suffered from myocardial infarction, chronic renal illness, and pneumonia and had high Charlson comorbidity index scores showed increased risks of mortality due to cerebral hemorrhage and infarction. Compared with the patients admitted from 1991 to 1996, those admitted from 1997 to 2002 and from 2003 to 2008 showed 15{\%}-20{\%} and 20{\%}-25{\%} reduction in one-year mortality risk in cerebral hemorrhage and infarction, respectively. This result demonstrates the continuous quality improvement of stroke management in the hospital from 1991 to 2008. Further reduction in one-year mortality can be achieved by early recognition and prompt treatment of certain comorbidities.",
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Improving the one-year mortality of stroke patients : An 18-year observation in a teaching hospital. / Chen, Hua Fen; Li, Chung-Yi; Lee, Siu Pak; Kwok, Yam Ting; Chu, Yiu Tong.

In: Tohoku Journal of Experimental Medicine, Vol. 232, No. 1, 13.02.2014, p. 47-54.

Research output: Contribution to journalArticle

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