The evaluation of the stroke unit in Croatia at the University Hospital Sestre milosrdnice, Zagreb: 1995-2006 experience

Supanc, Višnja and Vargek-Solter, Vesna and Bašić-Kes, Vanja and Breitenfeld, Tomislav and Ramić, Senad and Zavoreo, Iris and Jergović, Krešimir and Šetić, Mia and Biloglav, Zrinka and Demarin, Vida (2009) The evaluation of the stroke unit in Croatia at the University Hospital Sestre milosrdnice, Zagreb: 1995-2006 experience. Collegium Antropologicum, 33 (4). pp. 1233-8. ISSN 0350-6134

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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.

Abstract in Croatian

PROCJENA UČINKOVITOSTI JEDINICE ZA LIJEČENJE MOŽDANOG UDARA NA KLINICI ZA NEUROLOGIJU KB »SESTRE MILOSRDNICE«, ZAGREB, HRVATSKA, U RAZDOBLJU OD 1995. DO 2006. GODINE ----- Prikazani su rezultati procjene učinkovitosti Jedinice za liječenje moždanog udara (JLMU) na Klinici za neurologiju KB »Sestre milosrdnice« uspoređivanjem bolničkog mortaliteta u periodu prije (1995.–2000.) i poslije (2001.–2006.) njezinog uvođenja. Učinjena je i usporedba rizičnih čimbenika za nastanak bolesti, kao što su primjerice hipertenzija, šećerna bolest, atrijska fibrilacija i ishemična bolest srca, u populaciji preminulih bolesnika. Istraživanje je provedeno u dvanaestogodišnjem razdoblju tijekom kojeg je hospitalizirano 10,901 bolesnika s akutnim moždanim udarom, a preminulih je bilo 1,818. Uspoređivanjem mortaliteta bolesnika s akutnim moždanim udarom tijekom bolničkog liječenja i prevalencije rizičnih faktora među preminulim bolesnicima utvrđeno je da je prije uspostavljanja JLMU-a taj mortalitet iznosio 20,1%, dok se nakon njezinog utemeljenja statistički značajno snizio na 12,8% (p<0,001). Relativni rizik (RR) bio je 1,57, dok je procjena omjera šansi (engl. odds ratio, OR) pokazala 71%-tno povećanje šansi smrtnog ishoda u razdoblju prije osnivanja JLMU-a. Prevalencija šećerne bolesti, ishemične srčane bolesti i atrijske fibrilacije značajno je porasla u istraživanoj populaciji, dok je hipertenzija jedini rizični čimbenik koji bilježi statistički značajno smanjenje učestalosti (p<0,001). Ovim istraživanjem potvrdili smo da je organizacija i uspostavljanje JLMU-a povezana s zna- čajnim smanjenjem mortaliteta tijekom bolničkog liječenja bolesnika s akutnim moždanim udarom. Rezultati upućuju na potrebu razvoja i uspostavljanja mreže JLMU-a u Hrvatskoj čemu bi se trebao dati prioritet u budućoj organizaciji zdravstvene zaštite.

Item Type: Article
MeSH: Adult ; Aged ; Aged, 80 and over ; Croatia/epidemiology ; Female ; Hospital Mortality ; Hospital Units ; Humans ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Retrospective Studies ; Risk ; Stroke/mortality ; Stroke/therapy
Departments: Katedra za medicinsku statistiku, epidemiologiju i medicinsku informatiku
Depositing User: Marijan Šember
Status: Published
Creators:
CreatorsEmail
Supanc, VišnjaUNSPECIFIED
Vargek-Solter, VesnaUNSPECIFIED
Bašić-Kes, VanjaUNSPECIFIED
Breitenfeld, TomislavUNSPECIFIED
Ramić, SenadUNSPECIFIED
Zavoreo, IrisUNSPECIFIED
Jergović, KrešimirUNSPECIFIED
Šetić, MiaUNSPECIFIED
Biloglav, ZrinkaUNSPECIFIED
Demarin, VidaUNSPECIFIED
Date: December 2009
Date Deposited: 17 May 2010
Last Modified: 23 Sep 2011 16:11
Subjects: /
Related URLs:
    URI: http://medlib.mef.hr/id/eprint/769

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