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  • Quality of Care and One-Year Outcomes in Patients with Diabetes Hospitalised for Stroke or TIA: A Linked Registry Study

    Author(s)
    Olaiya, Muideen T
    Cadilhac, Dominique A
    Kim, Joosup
    Thrift, Amanda G
    Courten, Barbora de
    Andrew, Nadine E
    Grimley, Rohan
    Anderson, Craig S
    Sundararajan, Vijaya
    Lannin, Natasha A
    Levi, Christopher
    Dewey, Helen M
    Kilkenny, Monique F
    Griffith University Author(s)
    Grimley, Rohan
    Year published
    2021
    Metadata
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    Abstract
    OBJECTIVES: To evaluate key quality indicators for acute care and one-year outcomes following acute ischaemic stroke (IS), intracerebral haemorrhage (ICH), or transient ischaemic attack (TIA) by diabetes status. MATERIALS AND METHODS: Observational cohort study (2009-2013) using linked data from the Australian Stroke Clinical Registry and hospital records. Diabetes was ascertained through review of hospital records. Multilevel regression models were used to evaluate the association between diabetes and outcomes, including discharge destination, and mortality and hospital readmissions within one-year of stroke/TIA. RESULTS: ...
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    OBJECTIVES: To evaluate key quality indicators for acute care and one-year outcomes following acute ischaemic stroke (IS), intracerebral haemorrhage (ICH), or transient ischaemic attack (TIA) by diabetes status. MATERIALS AND METHODS: Observational cohort study (2009-2013) using linked data from the Australian Stroke Clinical Registry and hospital records. Diabetes was ascertained through review of hospital records. Multilevel regression models were used to evaluate the association between diabetes and outcomes, including discharge destination, and mortality and hospital readmissions within one-year of stroke/TIA. RESULTS: Among 14,132 patients (median age 76 years, 46% female), 22% had diabetes. Compared to patients without diabetes, those with diabetes were equally likely to receive stroke unit care, but were more often discharged on antihypertensive agents (79% vs. 68%) or with a care plan (50% vs. 47%). In patients with TIA, although 86% returned directly home after acute care, those with diabetes more often had a different discharge destination than those without diabetes. Diabetes was associated with greater all-cause mortality (hazard ratio 1.13, 95% CI 1.04-1.23) in patients with IS/ICH; and with both greater all-cause (1.81, CI 1.35-2.43) and CVD mortality (1.75, CI 1.06-2.91) in patients with TIA. Similarly, diabetes was associated with greater rates of all-cause readmission in both patients with IS/ICH and TIA. CONCLUSIONS: Despite good adherence to best care standards for acute stroke/TIA, patients with comorbid diabetes had worse outcomes at one-year than those without comorbid diabetes. Associations of diabetes with poorer outcomes were more pronounced in patients with TIA than those with IS/ICH.
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    Journal Title
    Journal of Stroke and Cerebrovascular Diseases
    Volume
    30
    Issue
    11
    DOI
    https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106083
    Subject
    Clinical sciences
    Endocrinology
    Diabetes
    Mortality/Survival
    Outcomes
    Quality
    Stroke
    Publication URI
    http://hdl.handle.net/10072/408950
    Collection
    • Journal articles

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