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Important factors in predicting mortality outcome from stroke: findings from the Anglia Stroke Clinical Network Evaluation Study.

Publication ,  Journal Article
Myint, PK; O Bachmann, M; Loke, YK; D Musgrave, S; Price, GM; Hale, R; Metcalf, AK; Turner, DA; Day, DJ; A Warburton, E; Potter, JF
Published in: Age Ageing
January 28, 2017

BACKGROUND: Although variation in stroke service provision and outcomes have been previously investigated, it is less well known what service characteristics are associated with reduced short- and medium-term mortality. METHODS: Data from a prospective multicentre study (2009–12) in eight acute regional NHS trusts with a catchment population of about 2.6 million were used to examine the prognostic value of patient-related factors and service characteristics on stroke mortality outcome at 7, 30 and 365 days post stroke, and time to death within 1 year. RESULTS: A total of 2,388 acute stroke patients (mean (standard deviation) 76.9 (12.7) years; 47.3% men, 87% ischaemic stroke) were included in the study. Among patients characteristics examined increasing age, haemorrhagic stroke, total anterior circulation stroke type, higher prestroke frailty, history of hypertension and ischaemic heart disease and admission hyperglycaemia predicted 1-year mortality. Additional inclusion of stroke service characteristics controlling for patient and service level characteristics showed varying prognostic impact of service characteristics on stroke mortality over the disease course during first year after stroke at different time points. The most consistent finding was the benefit of higher nursing levels; an increase in one trained nurses per 10 beds was associated with reductions in 30-day mortality of 11–28% (P < 0.0001) and in 1-year mortality of 8–12% (P < 0.001). CONCLUSIONS: There appears to be consistent and robust evidence of direct clinical benefit on mortality up to 1 year after acute stroke of higher numbers of trained nursing staff over and above that of other recognised mortality risk factors.

Duke Scholars

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Published In

Age Ageing

DOI

EISSN

1468-2834

Publication Date

January 28, 2017

Volume

46

Issue

1

Start / End Page

83 / 90

Location

England

Related Subject Headings

  • Workload
  • Time Factors
  • Stroke
  • Risk Factors
  • Prospective Studies
  • Prognosis
  • Personnel Staffing and Scheduling
  • Nursing Staff, Hospital
  • Nursing Service, Hospital
  • Middle Aged
 

Citation

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Myint, P. K., O Bachmann, M., Loke, Y. K., D Musgrave, S., Price, G. M., Hale, R., … Potter, J. F. (2017). Important factors in predicting mortality outcome from stroke: findings from the Anglia Stroke Clinical Network Evaluation Study. Age Ageing, 46(1), 83–90. https://doi.org/10.1093/ageing/afw175
Myint, Phyo Kyaw, Max O Bachmann, Yoon Kong Loke, Stanley D Musgrave, Gill M. Price, Rachel Hale, Anthony Kneale Metcalf, et al. “Important factors in predicting mortality outcome from stroke: findings from the Anglia Stroke Clinical Network Evaluation Study.Age Ageing 46, no. 1 (January 28, 2017): 83–90. https://doi.org/10.1093/ageing/afw175.
Myint PK, O Bachmann M, Loke YK, D Musgrave S, Price GM, Hale R, et al. Important factors in predicting mortality outcome from stroke: findings from the Anglia Stroke Clinical Network Evaluation Study. Age Ageing. 2017 Jan 28;46(1):83–90.
Myint, Phyo Kyaw, et al. “Important factors in predicting mortality outcome from stroke: findings from the Anglia Stroke Clinical Network Evaluation Study.Age Ageing, vol. 46, no. 1, Jan. 2017, pp. 83–90. Pubmed, doi:10.1093/ageing/afw175.
Myint PK, O Bachmann M, Loke YK, D Musgrave S, Price GM, Hale R, Metcalf AK, Turner DA, Day DJ, A Warburton E, Potter JF. Important factors in predicting mortality outcome from stroke: findings from the Anglia Stroke Clinical Network Evaluation Study. Age Ageing. 2017 Jan 28;46(1):83–90.
Journal cover image

Published In

Age Ageing

DOI

EISSN

1468-2834

Publication Date

January 28, 2017

Volume

46

Issue

1

Start / End Page

83 / 90

Location

England

Related Subject Headings

  • Workload
  • Time Factors
  • Stroke
  • Risk Factors
  • Prospective Studies
  • Prognosis
  • Personnel Staffing and Scheduling
  • Nursing Staff, Hospital
  • Nursing Service, Hospital
  • Middle Aged