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Tytuł:
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Trends in stroke outcomes at hospital discharge in first-ever stroke patients: Observations from the Malaysia National Stroke Registry (2009-2017).
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Autorzy:
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Chen XW; Public Health Medicine Department, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, Sungai Buloh 47000, Selangor, Malaysia; Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
Shafei MN; Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
Aziz ZA; Neurology Unit, General Medicine Department, Hospital Sultanah Nur Zahirah, Jalan Sultan Mahmud, 20400 Terengganu, Malaysia.
Sidek NN; Clinical Research Centre, Hospital Sultanah Nur Zahirah, Jalan Sultan Mahmud, 20400 Terengganu, Malaysia.
Musa KI; Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia. Electronic address: .
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Źródło:
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Journal of the neurological sciences [J Neurol Sci] 2019 Jun 15; Vol. 401, pp. 130-135. Date of Electronic Publication: 2019 Apr 11.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: Amsterdam : Elsevier, <19 ->
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MeSH Terms:
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Stroke/*therapy
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Disability Evaluation ; Disabled Persons/statistics & numerical data ; Female ; Humans ; Independent Living ; Longitudinal Studies ; Malaysia/epidemiology ; Male ; Middle Aged ; Patient Discharge ; Registries ; Retrospective Studies ; Sex Factors ; Stroke/mortality ; Treatment Outcome ; Young Adult
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Contributed Indexing:
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Keywords: Death; Functional dependence; Independence; Stroke outcomes
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Entry Date(s):
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Date Created: 20190420 Date Completed: 20200720 Latest Revision: 20200720
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Update Code:
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20240104
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DOI:
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10.1016/j.jns.2019.04.015
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PMID:
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31000206
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Background: Stroke outcomes could be a quality indicator across the continuum of care and inform stroke management policymaking. However, this topic has rarely to date been studied directly.
Aims: We sought to investigate recent trends in stroke outcomes at hospital discharge among first-ever stroke patients.
Methods: This was an analysis of data from the Malaysia National Stroke Registry. Patients aged 18 years or older documented as having a first episode of stroke in the registry were recruited. Subsequently, the comparison of proportions for overall and sex-specific stroke outcomes between years (from 2009 to 2017) was conducted. The primary outcome was modified Rankin Scale score, which was assessed at hospital discharge, and each patient was categorized as follows: 1) functional independence, 2) functional dependence, or 3) death for analysis.
Results: This study included 9361 first-ever stroke patients. Approximately 36.2% (3369) were discharged in an independence state, 53.1% (4945) experienced functional dependence, and 10.8% (1006) patients died at the time of hospital discharge. The percentage of patients who were discharged independently increased from 23.3% in 2009 to 46.5% in 2017, while that of patients discharged in a disabled state fell from 56.0% in 2009 to 45.6% in 2017. The percentage of death at discharge was reduced from 20.7% in 2009 to 7.8% in 2017. These findings suggest that the proportions of stroke outcomes at hospital discharge have changed significantly over time (p < 0.001), and there was a significant sex-related difference in stroke outcomes at hospital discharge following first stroke episode (p < 0.001).
Conclusions: Our data indicate there has been a significant change in stroke outcomes over the past nine years in Malaysia. This information ought to be considered in ongoing efforts of tertiary stroke prevention.
(Copyright © 2019 Elsevier B.V. All rights reserved.)
