Feasibility, safety and cost of outpatient management of acute minor ischaemic stroke: a population-based study
| Autor: | Peter M. Rothwell, Nicola L.M. Paul, Michela Simoni, Ramon Luengo-Fernandez, Silvia Koton, Olivia C. Geraghty |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Population Ambulatory Care Facilities Brain Ischemia Angina Sepsis Nursing care Secondary Prevention medicine Humans Outpatient clinic Prospective Studies cardiovascular diseases Medical prescription education Stroke Aged Hypolipidemic Agents education.field_of_study Inpatient care business.industry Anticoagulants Disease Management Health Care Costs medicine.disease Hospitalization Psychiatry and Mental health Ischemic Attack Transient Emergency medicine Feasibility Studies Female Surgery Neurology (clinical) business |
| Zdroj: | Journal of neurology, neurosurgery, and psychiatry. 84(3) |
| ISSN: | 1468-330X 0022-3050 |
| Popis: | BACKGROUND: Outpatient management safely and effectively prevents early recurrent stroke after transient ischaemic attack (TIA), but this approach may not be safe in patients with acute minor stroke. OBJECTIVE: To study outcomes of clinic and hospital-referred patients with TIA or minor stroke (National Institute of Health Stroke Scale score ≤3) in a prospective, population-based study (Oxford Vascular Study). RESULTS: Of 845 patients with TIA/stroke, 587 (69%) were referred directly to outpatient clinics and 258 (31%) directly to inpatient services. Of the 250 clinic-referred minor strokes (mean age 72.7 years), 237 (95%) were investigated, treated and discharged on the same day, of whom 16 (6.8%) were subsequently admitted to hospital within 30 days for recurrent stroke (n=6), sepsis (n=3), falls (n=3), bleeding (n=2), angina (n=1) and nursing care (n=1). The 150 patients (mean age 74.8 years) with minor stroke referred directly to hospital (median length-of-stay 9 days) had a similar 30-day readmission rate (9/150; 6.3%; p=0.83) after initial discharge and a similar 30-day risk of recurrent stroke (9/237 in clinic patients vs 8/150, OR=0.70, 0.27-1.80, p=0.61). Rates of prescription of secondary prevention medication after initial clinic/hospital discharge were higher in clinic-referred than in hospital-referred patients for antiplatelets/anticoagulants (p |
| Databáze: | OpenAIRE |
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