Original scientific paper
The Evaluation of the Stroke Unit in Croatia at the University Hospital »Sestre milosrdnice«, Zagreb: 1995–2006 Experience
Višnja Supanc
; Department of Neurology, University Hospital »Sestre milosrdnice«, Zagreb, Croatia
Vesna Vargek-Solter
; Department of Neurology, University Hospital »Sestre milosrdnice«, Zagreb, Croatia
Vanja Bašić-Kes
; Department of Neurology, University Hospital »Sestre milosrdnice«, Zagreb, Croatia
Tomislav Breitenfeld
; Department of Neurology, University Hospital »Sestre milosrdnice«, Zagreb, Croatia
Senad Ramić
; Department of Medical Statistics, Epidemiology and Medical Informatics, School of Public Health »Andrija Štampar«, School of Medicine, University of Zagreb, Zagreb, Croatia
Iris Zavoreo
; Department of Neurology, University Hospital »Sestre milosrdnice«, Zagreb, Croatia
Krešmir Jergović
; Department of Neurology, University Hospital »Sestre milosrdnice«, Zagreb, Croatia
Mia Šetić
; Department of Psychology, Faculty of Arts and Sciences, University of Rijeka, Rijeka, Croatia
Zrinka Biloglav
; Department of Medical Statistics, Epidemiology and Medical Informatics, School of Public Health »Andrija Štampar«, School of Medicine, University of Zagreb, Zagreb, Croatia
Vida Demarin
; Department of Neurology, University Hospital »Sestre milosrdnice«, Zagreb, Croatia
Abstract
This study evaluate the effects of the Stroke Unit (SU) in Croatia by comparing the in-hospital case fatality rate in the period before (1995–2000) and after (2001–2006) the implementation of SU and to compare the prevalence of risk factors, such as hypertension, diabetes mellitus (DM), atrial fibrillation (AF) and ischemic heart disease (IHD) among the patients who died. The study was conducted in twelve-year period during which 10 901 stroke patients were admitted to hospital and 1 818 of them died. The endpoints were in-hospital case fatality rate and prevalence of risk factors among the patients who died. Before the SU period the case fatality rate was 20.1%, whereas afterwards it decreased significantly to 12.8% (p<0.001). The relative risk (RR) was 1.57, while the estimate of the odds ratio (OR) showed a 71% increase in chances of death in the pre-SU period. The prevalence of DM, IHD and AF increased significantly, while hypertension was the only risk factor which significantly decreased (p<0.001). The results showed that the implementation of SU care is associated with a significant reduction of in-hospital case fatality rate of acute stroke patients which strongly suggests that development of the SU network in Croatia should be given priority in the health management.
Keywords
stroke mortality; stroke unit; Croatia; in-hospital case fatality
Hrčak ID:
51506
URI
Publication date:
1.12.2009.
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