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Acute Stroke Care in Dementia : A Cohort Study from the Swedish Dementia and Stroke Registries

Zupanic, Eva; Kåreholt, Ingemar; Norrving, Bo LU ; Secnik, Juraj; von Euler, Mia; Winblad, Bengt; Religa, Dorota; Kramberger, Milica Gregoric; Johnell, Kristina and Eriksdotter, Maria, et al. (2018) In Journal of Alzheimer's disease : JAD 66(1). p.185-194
Abstract

METHODS: Retrospective analysis of prospectively collected data 2010-2014 from the Swedish national dementia registry (SveDem) and the Swedish national stroke registry (Riksstroke). Patients with dementia who suffered an acute ischemic stroke (AIS) (n = 1,356) were compared with matched non-dementia AIS patients (n = 6,755). Outcomes included length of stay in a stroke unit, total length of hospitalization, and utilization of diagnostic tests and assessments.

RESULTS: The median age at stroke onset was 83 years. While patients with dementia were equally likely to be directly admitted to a stroke unit as their non-dementia counterparts, their stroke unit and total hospitalization length were shorter (10.5 versus 11.2 days and 11.6... (More)

METHODS: Retrospective analysis of prospectively collected data 2010-2014 from the Swedish national dementia registry (SveDem) and the Swedish national stroke registry (Riksstroke). Patients with dementia who suffered an acute ischemic stroke (AIS) (n = 1,356) were compared with matched non-dementia AIS patients (n = 6,755). Outcomes included length of stay in a stroke unit, total length of hospitalization, and utilization of diagnostic tests and assessments.

RESULTS: The median age at stroke onset was 83 years. While patients with dementia were equally likely to be directly admitted to a stroke unit as their non-dementia counterparts, their stroke unit and total hospitalization length were shorter (10.5 versus 11.2 days and 11.6 versus 13.5, respectively, p < 0.001). Dementia patients were less likely to receive carotid ultrasound (OR 0.36, 95% CI [0.30-0.42]) or undergo assessments by the interdisciplinary team members (physiotherapists, speech therapists, occupational therapists; p < 0.05 for all adjusted models). However, a similar proportion of patients received CT imaging (97.4% versus 98.6%, p = 0.001) and a swallowing assessment (90.7% versus 91.8%, p = 0.218).

CONCLUSIONS: Patients with dementia who suffer an ischemic stroke have equal access to direct stroke unit care compared to non-dementia patients; however, on average, their stay in a stroke unit and total hospitalization are shorter. Dementia patients are also less likely to receive specific diagnostic tests and assessments by the interdisciplinary stroke team.

BACKGROUND: Previous studies have shown that patients with dementia receive less testing and treatment for stroke.

OBJECTIVES: Our aim was to investigate hospital management of acute ischemic stroke in patients with and without dementia.

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Contribution to journal
publication status
published
subject
keywords
Cohort studies, dementia, hospital management, ischemic stroke
in
Journal of Alzheimer's disease : JAD
volume
66
issue
1
pages
185 - 194
publisher
IOS Press
external identifiers
  • scopus:85055146830
ISSN
1387-2877
DOI
10.3233/JAD-180653
language
English
LU publication?
yes
id
00a11b7c-c3c3-49ce-8095-a6b59ce63be8
date added to LUP
2018-12-07 15:03:28
date last changed
2019-01-06 14:19:14
@article{00a11b7c-c3c3-49ce-8095-a6b59ce63be8,
  abstract     = {<p>METHODS: Retrospective analysis of prospectively collected data 2010-2014 from the Swedish national dementia registry (SveDem) and the Swedish national stroke registry (Riksstroke). Patients with dementia who suffered an acute ischemic stroke (AIS) (n = 1,356) were compared with matched non-dementia AIS patients (n = 6,755). Outcomes included length of stay in a stroke unit, total length of hospitalization, and utilization of diagnostic tests and assessments.</p><p>RESULTS: The median age at stroke onset was 83 years. While patients with dementia were equally likely to be directly admitted to a stroke unit as their non-dementia counterparts, their stroke unit and total hospitalization length were shorter (10.5 versus 11.2 days and 11.6 versus 13.5, respectively, p &lt; 0.001). Dementia patients were less likely to receive carotid ultrasound (OR 0.36, 95% CI [0.30-0.42]) or undergo assessments by the interdisciplinary team members (physiotherapists, speech therapists, occupational therapists; p &lt; 0.05 for all adjusted models). However, a similar proportion of patients received CT imaging (97.4% versus 98.6%, p = 0.001) and a swallowing assessment (90.7% versus 91.8%, p = 0.218).</p><p>CONCLUSIONS: Patients with dementia who suffer an ischemic stroke have equal access to direct stroke unit care compared to non-dementia patients; however, on average, their stay in a stroke unit and total hospitalization are shorter. Dementia patients are also less likely to receive specific diagnostic tests and assessments by the interdisciplinary stroke team.</p><p>BACKGROUND: Previous studies have shown that patients with dementia receive less testing and treatment for stroke.</p><p>OBJECTIVES: Our aim was to investigate hospital management of acute ischemic stroke in patients with and without dementia.</p>},
  author       = {Zupanic, Eva and Kåreholt, Ingemar and Norrving, Bo and Secnik, Juraj and von Euler, Mia and Winblad, Bengt and Religa, Dorota and Kramberger, Milica Gregoric and Johnell, Kristina and Eriksdotter, Maria and Garcia-Ptacek, Sara},
  issn         = {1387-2877},
  keyword      = {Cohort studies,dementia,hospital management,ischemic stroke},
  language     = {eng},
  number       = {1},
  pages        = {185--194},
  publisher    = {IOS Press},
  series       = {Journal of Alzheimer's disease : JAD},
  title        = {Acute Stroke Care in Dementia : A Cohort Study from the Swedish Dementia and Stroke Registries},
  url          = {http://dx.doi.org/10.3233/JAD-180653},
  volume       = {66},
  year         = {2018},
}