Friday, January 11, 2019

Determinants of Case Fatality After Hospitalization for Stroke in France 2010 to 2015

My god, this is so simple. Your stroke leaders just have to write up exactly the cause of these deaths, write RFPs to researchers to solve them, write protocols based on the research, distribute those protocols to all stroke hospitals, likely get the Nobel prize in medicine.  If your stroke leaders can't see and implement these steps, replace them with stroke survivors. And look, an email address for your leaders to communicate to.

Determinants of Case Fatality After Hospitalization for Stroke in France 2010 to 2015


Originally publishedhttps://doi.org/10.1161/STROKEAHA.118.023495Stroke. 2019;0:STROKEAHA.118.023495

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

The online-only Data Supplement is available with this article at https://www.ahajournals.org/doi/suppl/10.1161/STROKEAHA.118.023495.
Correspondence to Amélie Gabet, MS, 14 rue du Val d’Osne, 94410 St Maurice, France. Email:

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