Age‐Specific and Sex‐Specific Trends in Life‐Sustaining Care After Acute Stroke

Background Temporal trends in life‐sustaining care after acute stroke are not well characterized. We sought to determine contemporary trends by age and sex in the use of life‐sustaining care after acute ischemic stroke and intracerebral hemorrhage in a large, population‐based cohort. Methods and Res...

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Autores principales:	Raed A. Joundi, Eric E. Smith, Amy Y. X. Yu, Mohammed Rashid, Jiming Fang, Moira K. Kapral
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	acute stroke epidemiology intensive care unit temporal trends Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/bb55800bad554caa81779c70e9d38235
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spelling	oai:doaj.org-article:bb55800bad554caa81779c70e9d382352021-11-23T11:36:35ZAge‐Specific and Sex‐Specific Trends in Life‐Sustaining Care After Acute Stroke10.1161/JAHA.121.0214992047-9980https://doaj.org/article/bb55800bad554caa81779c70e9d382352021-09-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.121.021499https://doaj.org/toc/2047-9980Background Temporal trends in life‐sustaining care after acute stroke are not well characterized. We sought to determine contemporary trends by age and sex in the use of life‐sustaining care after acute ischemic stroke and intracerebral hemorrhage in a large, population‐based cohort. Methods and Results We used linked administrative data to identify all hospitalizations for acute ischemic stroke or intracerebral hemorrhage in the province of Ontario, Canada, from 2003 to 2017. We calculated yearly proportions of intensive care unit admission, mechanical ventilation, percutaneous feeding tube placement, craniotomy/craniectomy, and tracheostomy. We used logistic regression models to evaluate the association of age and sex with life‐sustaining care and determined whether trends persisted after adjustment for baseline factors and estimated stroke severity. There were 137 358 people with acute ischemic stroke or intracerebral hemorrhage hospitalized during the study period. Between 2003 and 2017, there was an increase in the proportion receiving care in the intensive care unit (12.4% to 17.7%) and mechanical ventilation (4.4% to 6.6%). There was a small increase in craniotomy/craniectomy, a decrease in percutaneous feeding tube use, and no change in tracheostomy. Trends were generally consistent across stroke types and persisted after adjustment for comorbid conditions, stroke‐center type, and estimated stroke severity. After adjustment, women and those aged ≥80 years had lower odds of all life‐sustaining care, although the disparities in intensive care unit admission narrowed over time. Conclusions Use of life‐sustaining care after acute stroke increased between 2003 and 2017. Women and those at older ages had lower odds of intensive care, although the differences narrowed over time. Further research is needed to determine the reasons for these findings.Raed A. JoundiEric E. SmithAmy Y. X. YuMohammed RashidJiming FangMoira K. KapralWileyarticleacute strokeepidemiologyintensive care unittemporal trendsDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 18 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute stroke epidemiology intensive care unit temporal trends Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	acute stroke epidemiology intensive care unit temporal trends Diseases of the circulatory (Cardiovascular) system RC666-701 Raed A. Joundi Eric E. Smith Amy Y. X. Yu Mohammed Rashid Jiming Fang Moira K. Kapral Age‐Specific and Sex‐Specific Trends in Life‐Sustaining Care After Acute Stroke
description	Background Temporal trends in life‐sustaining care after acute stroke are not well characterized. We sought to determine contemporary trends by age and sex in the use of life‐sustaining care after acute ischemic stroke and intracerebral hemorrhage in a large, population‐based cohort. Methods and Results We used linked administrative data to identify all hospitalizations for acute ischemic stroke or intracerebral hemorrhage in the province of Ontario, Canada, from 2003 to 2017. We calculated yearly proportions of intensive care unit admission, mechanical ventilation, percutaneous feeding tube placement, craniotomy/craniectomy, and tracheostomy. We used logistic regression models to evaluate the association of age and sex with life‐sustaining care and determined whether trends persisted after adjustment for baseline factors and estimated stroke severity. There were 137 358 people with acute ischemic stroke or intracerebral hemorrhage hospitalized during the study period. Between 2003 and 2017, there was an increase in the proportion receiving care in the intensive care unit (12.4% to 17.7%) and mechanical ventilation (4.4% to 6.6%). There was a small increase in craniotomy/craniectomy, a decrease in percutaneous feeding tube use, and no change in tracheostomy. Trends were generally consistent across stroke types and persisted after adjustment for comorbid conditions, stroke‐center type, and estimated stroke severity. After adjustment, women and those aged ≥80 years had lower odds of all life‐sustaining care, although the disparities in intensive care unit admission narrowed over time. Conclusions Use of life‐sustaining care after acute stroke increased between 2003 and 2017. Women and those at older ages had lower odds of intensive care, although the differences narrowed over time. Further research is needed to determine the reasons for these findings.
format	article
author	Raed A. Joundi Eric E. Smith Amy Y. X. Yu Mohammed Rashid Jiming Fang Moira K. Kapral
author_facet	Raed A. Joundi Eric E. Smith Amy Y. X. Yu Mohammed Rashid Jiming Fang Moira K. Kapral
author_sort	Raed A. Joundi
title	Age‐Specific and Sex‐Specific Trends in Life‐Sustaining Care After Acute Stroke
title_short	Age‐Specific and Sex‐Specific Trends in Life‐Sustaining Care After Acute Stroke
title_full	Age‐Specific and Sex‐Specific Trends in Life‐Sustaining Care After Acute Stroke
title_fullStr	Age‐Specific and Sex‐Specific Trends in Life‐Sustaining Care After Acute Stroke
title_full_unstemmed	Age‐Specific and Sex‐Specific Trends in Life‐Sustaining Care After Acute Stroke
title_sort	age‐specific and sex‐specific trends in life‐sustaining care after acute stroke
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/bb55800bad554caa81779c70e9d38235
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Age‐Specific and Sex‐Specific Trends in Life‐Sustaining Care After Acute Stroke

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