Disparities in Stroke Patient-Reported Outcomes Measurement Between Healthcare Systems in Brazil.

Autor:	Martins SCO; Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil.; Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil.; Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.; Brazilian Stroke Network, Porto Alegre, Brazil., Borelli WV; Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil.; Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.; Universidade Federal do Rio Grande do Sul, Pharmacology and Therapeutics Research Program, Porto Alegre, Brazil., Secchi TL; Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil.; Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil.; Brazilian Stroke Network, Porto Alegre, Brazil.; Universidade Federal do Rio Grande do Sul, Postgraduate in Medical Sciences, Porto Alegre, Brazil., Mantovani GP; Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil.; Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.; Brazilian Stroke Network, Porto Alegre, Brazil., Pille A; Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil.; Brazilian Stroke Network, Porto Alegre, Brazil.; Universidade Federal do Rio Grande do Sul, Postgraduate in Medical Sciences, Porto Alegre, Brazil., Mora Cuervo DL; Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil.; Brazilian Stroke Network, Porto Alegre, Brazil., Carbonera LA; Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil.; Brazilian Stroke Network, Porto Alegre, Brazil., de Souza AC; Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil.; Brazilian Stroke Network, Porto Alegre, Brazil.; Universidade Federal do Rio Grande do Sul, Postgraduate in Medical Sciences, Porto Alegre, Brazil., Martins MCO; Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil.; Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil.; Brazilian Stroke Network, Porto Alegre, Brazil., Brondani R; Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil.; Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.; Brazilian Stroke Network, Porto Alegre, Brazil., de Almeida AG; Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil.; Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil.; Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.; Brazilian Stroke Network, Porto Alegre, Brazil., Dal Pizzol A; Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil.; Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil.; Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.; Brazilian Stroke Network, Porto Alegre, Brazil., Dos Santos FP; Hospital Moinhos de Vento, Neurology Service and Postgraduate in Stroke Neurology, Porto Alegre, Brazil.; Hospital de Clínicas de Porto Alegre, Neurology Service, Porto Alegre, Brazil.; Brazilian Stroke Network, Porto Alegre, Brazil., Alves AC; Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil., Meier NS; Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil., Andrade GPB; Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil., Maciel PA; Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil., Weber A; Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil., Machado GD; Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil., Parrini M; Hospital Moinhos de Vento, Porto Alegre, Brazil., Nasi LA; Hospital Moinhos de Vento, Porto Alegre, Brazil.
Jazyk:	angličtina
Zdroj:	Frontiers in neurology [Front Neurol] 2022 May 06; Vol. 13, pp. 857094. Date of Electronic Publication: 2022 May 06 (Print Publication: 2022).
DOI:	10.3389/fneur.2022.857094
Abstrakt:	Introduction: Acute stroke interventions, such as stroke units and reperfusion therapy, have the potential to improve outcomes. However, there are many disparities in patient characteristics and access to the best stroke care. Thus, we aim to compare patient-reported outcome measures (PROMs) after stroke in two stroke centers representing the public and private healthcare systems in Brazil. Methods: PROMs through the International Consortium for Health Outcomes Measures (ICHOM) were assessed at 90 days after the stroke to compare two Brazilian hospitals in southern Brazil: a public university and a private stroke center, both with stroke protocols and stroke units. Results: When compared with the private setting ( n = 165), patients from the public hospital ( n = 175) were younger, had poorer control of risk factors, had more frequent previous strokes, and arrived with more severe strokes. Both hospitals had a similar percentage of IV thrombolysis treatment. Only 5 patients received mechanical thrombectomy (MT), all in the private hospital. Public hospital patients presented significantly worse outcomes at 3 months, including worse quality of life and functional dependence (60 vs. 48%, p = 0.03). Poor outcome, as measured by the mRS score, was significantly associated with older age, higher NIHSS score, and the presence of heart failure. However, the public practice was a strong predictor of any self-reported disability. Conclusion: Patients assisted at a good quality public stroke center with the same protocol used in the private hospital presented worse disability as measured by mRS and patient-reported outcome measures, with greater inability to communicate, dress, toilet, feed, and walk. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Martins, Borelli, Secchi, Mantovani, Pille, Mora Cuervo, Carbonera, Souza, Martins, Brondani, Almeida, Dal Pizzol, Santos, Alves, Meier, Andrade, Maciel, Weber, Machado, Parrini and Nasi.)
Databáze:	MEDLINE
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