Análisis de recursos asistenciales para el ictus en España en 2012: ¿beneficios de la Estrategia del Ictus del Sistema Nacional de Salud?

Fernández, J.C. López; Vallejo, J. Masjuán; Lara, J. Arenillas; González, Manuel; Paniagua, Enrique Botia; Naranjo, I. Casado; Arbona, E. Deyá; Soriano, B. Escribano; Guerrero, Mariana; Fuentes, Blanca; Culleré, J. Gállego; Sclarskyi, D. Geffners; Núñez, A. Gil; Escalonilla, C. Gómez; Martin, Anthony; Ramírez, I. Legarda; Montero, J.L. Maciñeiras; Álvarez, F. Moniche; Muñoz, Roberto; García, Francisco Purroy; Moreno, Juan Mozas; Amandix, M. Rebollo Álvarez; Roquer, Jaume; Borrego, Francisco Rubio; Segura, Tomás; Ponza, M. Serrano; García, J. Tejada; Juste, C. Tejero; Sánchez, J.A. Vidal

doi:10.1016/j.nrl.2013.06.017

Cited by 10 publications

(1 citation statement)

References 32 publications

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“…Given that we did not include patients hospitalised in departments without stroke units, these results are not representative of all the Spanish stroke population. Thus, as a limitation we notice that these results are valid only for the percentage of stroke patients that are admitted into a stroke unit [ 44 ]. This figure has increased during the last years allowing the patients to receive a specific and proactive treatment.…”

Section: Discussionmentioning

confidence: 99%

Outcomes measured by mortality rates, quality of life and degree of autonomy in the first year in stroke units in Spain

Mar

Masjuán

Oliva‐Moreno

et al. 2015

Health Qual Life Outcomes

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IntroductionThe primary objective of this sub analysis of the CONOCES study was to analyse outcomes in terms of mortality rates, quality of life and degree of autonomy over the first year in patients admitted to stroke units in Spain. The secondary objective was to identify the factors determining good prognosis.MethodsWe studied a sample of patients who had suffered a confirmed stroke and been admitted to a Stroke Unit in the Spanish healthcare system. Socio-demographic and clinical variables and variables related to the level of severity (NIHSS), the level of autonomy (Barthel, modified Rankin) and quality of life (EQ-5D) were recorded at the time of admission and then three months and one year after the event. Factors determining prognosis were analysed using logistic regression and ROC curves.ResultsA total of 321 patients were recruited, 33% of whom received thrombolytic treatment, which was associated with better results on the Barthel and the modified Rankin scales and in terms of the risk of death. Mean quality of life measured through EQ-5D improved from 0.57 at discharge to 0.65 one year later. Full autonomy level measured by Barthel index increased from 30.1% at discharge to 52.8% at one year and by the modified Rankin scale from 51% to 71%. The rates for in-hospital and 1-year mortality were 5.9% and 17.4% respectively. Low NIHSS scores were associated with a good prognosis with all the outcome variables. The three instruments applied (NIHSS, Barthel and modified Rankin scales) on admission showed good discriminative ability for patient prognosis in the ROC curves.ConclusionsThere has been a change in the prognosis for stroke in Spain in recent years as the quality of life at 1 year observed in our study is clearly higher than that obtained in other Spanish studies conducted previously. Moreover, survival and functional outcome have also improved following the introduction of a new model of care. These results clearly promote extension of the model based on stroke units and reinforced rehabilitation to the majority of the more than 100,000 strokes that occur annually in Spain.

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Section: Discussionmentioning

confidence: 99%