Prevention after stroke: A quality assurance study.
Acta Neurol Scand
; 143(6): 646-652, 2021 Jun.
Article
en En
| MEDLINE
| ID: mdl-33764498
OBJECTIVES: In 1997, the Copenhagen Stroke Study revealed that stroke was recurrent in 23% of patients admitted with a stroke. Predictors of recurrence were history of transient ischaemic attack, atrial fibrillation, male gender and hypertension. In 2011, the Danish recurrence rate was 25%. With the aim of preventing recurrent stroke, a preventive clinic was established in 2014 at the Department of Neurology, Herlev Hospital. Data from the preventive clinic are analysed in the present study. MATERIALS AND METHODS: Data from visits to the clinic from October 2014 to October 2016 were collected from electronic medical records. Data on subsequent admissions with stroke were collected from October 2014 to the end of 2017. Data were collected and analyzed as a means of quality assurance. RESULTS: Data from 1083 patients showed that half of the patients were hypertensive at discharge regardless of admission with first ever or recurrent stroke. Nurses at the clinic initiated or intensified antihypertensive medication in 40% of patients. Blood pressure was at target in 64% of patients at last visit to the clinic. Stepwise Cox proportional hazard regression analysis of 1024 patients admitted with ischaemic stroke or transient ischaemic attack showed that tobacco smoking (HR 1.80), admission with a recurrent stroke (HR 1.76) and cholesterol-lowering treatment (HR 1.67) were independent predictors of stroke recurrence. CONCLUSIONS: The recurrence rate in Denmark has remained unchanged for two decades. Risk factors for recurrence seem to change over time. Identification and treatment of actual risk factors may be a way to reduce recurrence.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Garantía de la Calidad de Atención de Salud
/
Accidente Cerebrovascular
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Prevención Secundaria
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
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Aged80
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Female
/
Humans
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Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Acta Neurol Scand
Año:
2021
Tipo del documento:
Article
País de afiliación:
Dinamarca
Pais de publicación:
Dinamarca