Quality of early stroke care and long-term mortality in patients with acute stroke: A nationwide follow-up study

European Stroke Journal, 2024 · DOI: 10.1177/23969873241249580 · Published: April 8, 2024

Simple Explanation

This study investigates the link between the quality of early stroke care and how long patients live after a stroke. It looks at whether following guidelines for stroke treatment affects long-term survival rates. The researchers analyzed data from Danish healthcare registries, focusing on patients admitted for stroke between 2008 and 2020. They assessed the quality of stroke care based on 10 performance measures and tracked patient mortality over time. The study found that higher quality of early stroke care was associated with lower long-term mortality. Patients who received care that adhered to all performance measures had a better chance of survival compared to those who received lower quality care.

Study Duration

2008 to 2020

Participants

102,742 patients with incident stroke in Denmark

Evidence Level

Not specified

Key Findings

1
Fulfilment of individual process performance measures (PPMs) was associated with adjusted hazard rate ratios of death between 0.76 and 0.96.
2
Patients with 100% fulfilment of all PPMs had a lower 10-year post-stroke mortality (adjusted risk ratio 0.90) compared to the patients with 0%–49% fulfilment.
3
High quality of early stroke care was associated with lower long-term mortality following both ICH and ischaemic stroke.

Research Summary

This nationwide study examined the association between the quality of early stroke care, measured by process performance measures (PPMs), and long-term mortality in patients with acute stroke in Denmark. The study included 102,742 patients admitted with incident stroke between 2008 and 2020 and found that higher fulfilment of PPMs was associated with lower 10-year mortality. The findings emphasize the importance of continued attention to delivering high-quality early stroke care to improve long-term outcomes for stroke patients.

Practical Implications

Improve Stroke Care Quality

Continued focus on enhancing the quality of early stroke care is essential for reducing long-term mortality among stroke patients.

Multidisciplinary Approach

Implement a multidisciplinary approach in early stroke care to address various aspects of patient needs and improve overall outcomes.

Targeted Interventions

Focus on specific PPMs that demonstrate the most significant impact on long-term mortality to optimize stroke care protocols.

Study Limitations

1
Observational study design precludes direct assessment of cause-effect relationship.
2
All-cause mortality as the chosen outcome, which may include deaths unrelated to stroke.
3
Potential for residual confounding despite multivariable adjustment.

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