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Trends in 10-year survival of patients with stroke hospitalized between 1980 and 2000: the Minnesota stroke survey.

ABSTRACT: We report on trends in poststroke survival, both in the early period after stroke and over the long term. We examine these trends by stroke subtype.The Minnesota Stroke Survey is a study of all hospitalized patients with acute stroke aged 30 to 74 years in the Minneapolis-St Paul metropolis. Validated stroke events were sampled for survey years 1980, 1985, 1990, 1995, and 2000 and subtyped as ischemic or hemorrhagic by neuroimaging for survey years 1990, 1995, and 2000. Survival was obtained by linkage to vital statistics data through the year 2010.There were 3773 acute stroke events. Age-adjusted 10-year survival improved from 1980 to 2000 (men 29.5% and 46.5%; P<0.0001; women 32.6% and 50.5%; P<0.0001). Ten-year ischemic stroke survival (n=1667) improved from 1990 to 2000 (men 35.3% and 50%; P=0.0001; women 38% and 55.3%; P<0.0001). Ten-year hemorrhagic stroke survival showed a trend toward improvement, but this (n=489) did not reach statistical significance, perhaps because of their smaller number (men 29.7% and 45.8%; P=0.06; women 39.2% and 49.6%; P=0.2). Markers of stroke severity including unconsciousness or major neurological deficits at admission declined from 1980 to 2000 while neuroimaging use increased.These poststroke survival trends are likely because of multiple factors, including more sensitive case ascertainment shifting the case mix toward less severe strokes, improved stroke care and risk factor management, and overall improvements in population health and longevity.

SUBMITTER: Lakshminarayan K

PROVIDER: S-EPMC4768867 | biostudies-literature | 2014 Sep

REPOSITORIES: biostudies-literature

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Trends in 10-year survival of patients with stroke hospitalized between 1980 and 2000: the Minnesota stroke survey.

Lakshminarayan Kamakshi K Berger Alan K AK Fuller Candace C CC Jacobs David R DR Anderson David C DC Steffen Lyn M LM Sillah Arthur A Luepker Russell V RV

Stroke 20140715 9

<h4>Background and purpose</h4>We report on trends in poststroke survival, both in the early period after stroke and over the long term. We examine these trends by stroke subtype.<h4>Methods</h4>The Minnesota Stroke Survey is a study of all hospitalized patients with acute stroke aged 30 to 74 years in the Minneapolis-St Paul metropolis. Validated stroke events were sampled for survey years 1980, 1985, 1990, 1995, and 2000 and subtyped as ischemic or hemorrhagic by neuroimaging for survey years ...[more]

PMID: 25028450

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Project description:IntroductionAcross all specialties, economic pressure is driving increased utilization of outpatient surgery when feasible.AimsOur aims were to analyze national trends of penile prosthesis (PP) surgery and to examine patient and hospital characteristics, and perioperative complications in the inpatient setting.MethodsWe analyzed data from National Inpatient Sample. Patients in NIS who underwent PP insertion between 2000 and 2010 were included.Main outcome measuresOur main outcomes were the number of inpatient PP procedures, type of prosthesis, patient demographics, comorbidities, hospital characteristics, and immediate perioperative complications.ResultsThere was a progressive and dramatic decline by nearly half in the number of both inflatable (IPP) and noninflatable (NIPP) inpatient insertions performed from 2000 to 2010 (P = 0.0001). The overall rate of inpatient complications for PP insertion was 13.5%. Patients with three or more comorbidities were found to have a higher risk of complications than patients with no comorbidities (OR = 1.45, 95% CI = 1.18-1.78) (P = 0.0001). Surgeries performed in high-volume hospitals (10 or more PP cases per year) were associated with reduced risk of complications (OR = 0.6) (P < 0.0001). There was a dramatic decrease in inpatient setting for PP placement in high-volume hospitals (32% in 2000 compared with 6% in 2010; P < 0.0001), and when compared with lower volume hospitals. NIPP was more likely performed in younger patients and in community hospitals, and less likely in white patients. Medicaid health insurance was associated with much higher rate of NIPP insertion than other types of insurance.ConclusionsThe number of PP procedures performed in the inpatient setting declined between 2000 and 2010, likely reflecting a shift toward increasing outpatient procedures. Our data also suggest a better outcome for patients having the procedure done at a high-volume center in terms of inpatient complications. Alwaal A, Harris CR, Hussein AA, Sanford TH, McCulloch CE, Shindel AW, and Breyer BN. The decline of inpatient penile prosthesis over the 10-year period, 2000-2010. Sex Med 2015;3:280-286.

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Trends in 10-year survival of patients with stroke hospitalized between 1980 and 2000: the Minnesota stroke survey.

Publications

Trends in 10-year survival of patients with stroke hospitalized between 1980 and 2000: the Minnesota stroke survey.

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