People who have in-hospital strokes experience fewer fatalities, but are more likely to have severe strokes, longer hospital stays and increased disability
It is estimated that 4 to 17 percent of strokes occur while people are already hospitalized for other reasons. Because these people are already receiving care, there is an opportunity for rapid treatment; however, little is known about the outcomes of those who experience in-hospital strokes.
To address this issue, Dr. Moira Kapral (TGHRI Senior Scientist) and Dr. Alexandra Saltman (UHN medical resident) used data from the Ontario Stroke Registry to examine the care and outcomes of almost 30,000 stroke patients across the province. While the team found that there were fewer fatalities amongst people who experienced an in-hospital stroke after adjusting for various factors, they also found that these people were more likely to experience more severe strokes, longer hospital stays and greater levels of disability.
One possible explanation for this could be that those who experienced in-hospital strokes had more health problems at the outset; as such, standard stroke treatments were often hindered by existing health complications. For example, certain stroke medications cannot be used when a patient is recovering from surgery.
Dr. Kapral states, "Although we cannot comment on the specific reasons for the different outcomes of in-hospital stroke patients, our study reinforces the need to develop standardized approaches for recognizing and managing strokes within the hospital setting."
This work was supported by the Canadian Stroke Network, the Heart and Stroke Foundation of Ontario, and the Toronto General & Western Hospital Foundation. Image from Thierry Geoffroy (Wikimedia Commons).
Care and outcomes of patients with in-hospital stroke. Saltman AP, Silver FL, Fang J, Stamplecoski M, Kapral MK. JAMA Neurology. 2015 May 4. [Pubmed abstract]