| 1. |
- Eriksson, Marie, 1970-, et al.
(författare)
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Sex differences in stroke care and outcome in the Swedish national quality register for stroke care
- 2009
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Ingår i: Stroke. - New York : American Heart Association. - 0039-2499 .- 1524-4628. ; 40:3, s. 909-914
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: Previous reports concerning sex-related differences in stroke management and outcome are inconsistent and are sometimes difficult to interpret. We used data from a national stroke register to further explore possible differences between men and women in baseline characteristics, stroke treatment, and outcome.Methods: This study included 24633 stroke events registered in Riks-Stroke, the Swedish national quality register for stroke care, during 2006. Information on background variables and treatment was collected during the hospital stay. After 3 months, the patients' living situation and outcome were assessed.Results: Women were older than men when they had their stroke (mean age, 78.4 versus 73.6 years; P<0.001). On admission to the hospital, women were more often unconscious. Among conscious patients, there was no sex-related difference in the use of stroke unit care. Men and women had equal probability to receive thrombolysis and oral anticoagulants. Women were more likely to develop deep venous thromboses and fractures, whereas men were more likely to develop pneumonia during their hospital stay. Women had a lower 3-month survival, a difference that was associated with higher age and impaired level of consciousness on admission. Women were less often living at home at the 3-month follow-up. However, the difference in residency was not present in patients <85 years who were living at home without community support before the stroke.Conclusions: Reported sex differences in stroke care and outcome were mainly explained by the women's higher age and lower level of consciousness on admission.
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| 2. |
- Ghatnekar, Ola, et al.
(författare)
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The effect of atrial fibrillation on stroke-related inpatient costs in Sweden : a 3-year analysis of registry incidence data from 2001
- 2008
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Ingår i: Value in Health. - : Elsevier BV. - 1098-3015 .- 1524-4733. ; 11:5, s. 862-868
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Atrial fibrillation (AF) is an important risk factor for stroke. It is prevalent in approximately one-fourth of stroke patients, and predictive of worse outcomes. This study aimed to analyze the effect of AF on stroke-related inpatient costs among first-ever stroke patients in Sweden.Methods: Hospitalizations and death records were monitored for 3 years in 6611 first-ever stroke patients. For stroke as primary diagnosis, inpatient costs were calculated on the basis of length of stay at different wards. For stroke as secondary diagnosis, costs were based on diagnosis-related groups.Results: Patients with AF (24% of all patients) were older (80 years vs. 73 years), had a higher prevalence of hypertension (49% vs. 41%) and/or diabetes (22% vs. 19%), higher risk of experiencing a restroke, and higher case fatality rate (43% vs. 25%) than patients without AF. The average cost per patient over 3 years was euro9004, with no statistically significant difference between AF and non-AF patients. However, a multiple regression analysis showed that the presence of AF resulted in higher costs after considering a number of background factors. Among patients surviving the index event, AF patients had on average euro818 higher inpatient costs over 3 years than non-AF patients (euro10,192 vs. euro9374, P < 0.01). The difference in costs was highest for patients aged <65 years, with a difference of euro4412 (P < 0.01).Conclusion: AF-related strokes are associated with higher 3-year inpatient costs than non-AF strokes when controlling for factors such as case fatality rates, other risk factors for stroke, and age.
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| 3. |
- Lindgren, Peter, et al.
(författare)
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Utility loss and indirect costs after stroke in Sweden
- 2008
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Ingår i: European Journal of Cardiovascular Prevention & Rehabilitation. - Philadelphia : Lippincott Williams & Wilkins. - 1741-8267 .- 1741-8275. ; 15:2, s. 230-233
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Currently little data exist on the development of quality of life over time in patients suffering from stroke, in particular using instruments that can be adapted in economic studies. The purpose of the study was to assess the utility loss and indirect costs following a stroke in Sweden.DESIGN: A cross-sectional mail survey. METHODS: In collaboration with the National Stroke registry (RIKS-STROKE), a questionnaire consisting of the EuroQol-5D and questions regarding the present working status and the status prior to the stroke was mailed to patients below 76 years of age at six participating centres. The questionnaire was mailed to 393 patients in total, divided into groups with 3, 6, 9 or 12 months having passed since the stroke. The EuroQol-5D scores were converted to utility scores using the UK social tariff. Indirect costs were valued according to the average salary+employer contributions.RESULTS: A total of 275 questionnaires (70%) were returned. Utility scores were similar over time: 0.65, 0.75, 0.63, and 0.67 at 3, 6, 9 and 12 months, respectively. Regression analyses revealed a tendency for lower utility scores among women, but no significant differences overall. Among patients in the working ages, a stroke caused 18.5 work weeks lost, corresponding to an indirect cost of 120,000 Swedish Kronor (SEK) (13,200euro, 95% confidence interval 82,541-160,050 SEK, 9080-17 605euro).CONCLUSIONS: Stroke causes a significant reduction in utility and causes high indirect costs. A substantial improvement was not noted over time, which is important to consider in economic models.
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| 4. |
- Röding, Jenny, et al.
(författare)
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Perceived impaired physical and cognitive functions after stroke in men and women between 18 and 55 years of age – a national survey
- 2009
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 31:13, s. 1092-1099
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. We describe self-reported consequences for physical and cognitive functions, detect possible gender differences, and find factors that were associated with deteriorated physical function in younger stroke patients, independent in their personal activities of daily life.Methods. This study involved all first ever stroke patients, aged 18-55 years, registered in the Swedish national quality register for stroke. A questionnaire was answered by 1068 patients 8-36 months after the stroke. Changes were sought in physical and cognitive functions as compared with the pre-stroke condition.Results. Eight hundred and sixty-seven patients (83%) were independent in personal activities of daily life. Significant differences between men and women were found: deteriorated physical ability was reported by 56-71% of the men and 65-79% of the women; deteriorated cognitive function was reported by 48-57% of the men and 57-68% of the women. Many patients (70% men, 77% women) reported that they had received insufficient information about physical exertion. Significant associations were found between deteriorated physical function and deteriorated cognitive function as well as fear of physical exertion.Conclusions. Deterioration was found in physical and cognitive functions greater in women then in men. Insecurity regarding physical exertion existed indicating that younger stroke patients might need information directly aimed at physical functioning and more gender specific than today. This study has raised the awareness that there also might be gender differences in other fields, which needs further studies.
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