Abstract
Background and Purpose—
The
aims of this study were to (1) describe early and late case fatality
rates after stroke in France, (2) evaluate whether their determinants
differed, and (3) analyze time trends between 2010 and 2015.
Methods—
Data
were extracted from the Système National des données de santé database.
Patients hospitalized for stroke each year from 2010 to 2015, aged ≥18
years, and affiliated to the general insurance scheme were selected. Cox
regressions were used to separately analyze determinants of 30-day and
31- to 365-day case fatality rates for each stroke type (ischemic,
intracerebral hemorrhage, and subarachnoid hemorrhage).
Results—
In
2015, of the 73 124 persons hospitalized for stroke, 26.8% died in the
following year, with the majority of deaths occurring within the first
30 days (56.9%). Nonadmission to a stroke unit, older age, and having
comorbidities were all associated with a poorer 30-day and 31- to
365-day prognosis. Female sex was associated with a lower 31- to 365-day
case fatality rate for all patients with stroke. Living in an area with
a high deprivation index was associated with both higher 30-day and 31-
to 365-day case fatality rates for all stroke types. Between 2010 and
2015, significant decreases in both 30-day and 31- to 365-day case
fatality rates for ischemic patients were observed.
Conclusions—
Case
fatality rates after stroke remained high in 2015 in France, despite
major improvements in stroke care and organization. Improvement in
stroke awareness and preparedness, particularly in the most deprived
areas, together with better follow-up after the acute phase are urgently
needed.(Fuck no, you don't need awareness, you need to address and solve why your 30 day deaths remain high.)
Footnotes
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