INTRODUCTION: This article in this supplement issue on the Performance, Effectiveness, and Costs of Treatment episodes (PERFECT) project describes trends in Finnish stroke treatment and outcome. MATERIAL AND METHODS: The PERFECT Stroke study uses multiple national registry linkages at individual patient level to produce a national stroke database with comprehensive follow-up of all hospital-treated stroke patients in Finland. RESULTS: There were 94,316 incident stroke patients treated in Finnish hospitals from 1999 to 2007. Lengths-of-stays decreased after ischemic stroke (IS), and increased after intracerebral (ICH) and subarachnoid (SAH) hemorrhage. Ten-year survival improved in IS (hazard ratio 0.75; 95% CI 0.71-0.79) and ICH patients (0.88; 0.79-0.97), increasing median survival by 2 and 1 life-years respectively. This has translated into more days spent home among IS patients, but not among ICH patients. Treatment by neurologists improved the survival of IS (odds ratio [OR] 1.77; 95% CI 1.70-1.84) and ICH patients (OR 1.55; 95% CI 1.40-1.69), and treatment by neurosurgeons of SAH patients (OR 2.66; 95% CI 2.25-3.16), the effects were further improved by care in specialized stroke centers. DISCUSSION: The survival of Finnish IS and ICH patients has improved. Specialized acute care was associated with improved outcome.
INTRODUCTION: This article in this supplement issue on the Performance, Effectiveness, and Costs of Treatment episodes (PERFECT) project describes trends in Finnish stroke treatment and outcome. MATERIAL AND METHODS: The PERFECT Stroke study uses multiple national registry linkages at individual patient level to produce a national stroke database with comprehensive follow-up of all hospital-treated strokepatients in Finland. RESULTS: There were 94,316 incident strokepatients treated in Finnish hospitals from 1999 to 2007. Lengths-of-stays decreased after ischemic stroke (IS), and increased after intracerebral (ICH) and subarachnoid (SAH) hemorrhage. Ten-year survival improved in IS (hazard ratio 0.75; 95% CI 0.71-0.79) and ICHpatients (0.88; 0.79-0.97), increasing median survival by 2 and 1 life-years respectively. This has translated into more days spent home among IS patients, but not among ICHpatients. Treatment by neurologists improved the survival of IS (odds ratio [OR] 1.77; 95% CI 1.70-1.84) and ICHpatients (OR 1.55; 95% CI 1.40-1.69), and treatment by neurosurgeons of SAH patients (OR 2.66; 95% CI 2.25-3.16), the effects were further improved by care in specialized stroke centers. DISCUSSION: The survival of Finnish IS and ICHpatients has improved. Specialized acute care was associated with improved outcome.
Authors: Atte Meretoja; Monica Acciarresi; Rufus O Akinyemi; Bruce Campbell; Dar Dowlatshahi; Coralie English; Nils Henninger; Alexandre Poppe; Jukka Putaala; Monica Saini; Shoichiro Sato; Bo Wu; Michael Brainin; Bo Norrving; Stephen Davis Journal: Int J Stroke Date: 2017-03-28 Impact factor: 5.266
Authors: Darin B Zahuranec; Lynda D Lisabeth; Brisa N Sánchez; Melinda A Smith; Devin L Brown; Nelda M Garcia; Lesli E Skolarus; William J Meurer; James F Burke; Eric E Adelman; Lewis B Morgenstern Journal: Neurology Date: 2014-05-16 Impact factor: 9.910
Authors: Maria Carlsson; Tom Wilsgaard; Stein Harald Johnsen; Anne Merete Vangen-Lønne; Maja-Lisa Løchen; Inger Njølstad; Ellisiv Bøgeberg Mathiesen Journal: Cerebrovasc Dis Extra Date: 2016-08-13