Early and One-Year Outcomes of Acute Stroke in the Industrial Region of Poland During the Decade 2006–2015: The Silesian Stroke Registry

Abstract

Background: Poland, classified as a high-income country, is still considered to have a high cardiovascular risk population. During the last decade, the standards of care in acute stroke (AS) had markedly improved; thus, we aimed to assess whether and how it translated into early and late outcomes. Methods: Silesian Stroke Registry was created from the administrative database of the public, obligatory, health ­insurer in Poland. The AS cases were selected based on primary diagnosis coded in ICD-10 as I60-I64 for years 2006–2015 (n = 120,844). Index hospitalization together with data on re-hospitalizations, procedures, ambulatory visits, rehabilitation and all-cause deaths in a 1-year follow-up were analyzed. Results: The rates of admissions per 100,000 adult population varied between 41–47 for haemorrhagic and 257–275 for ischaemic stroke with substantial decrease in almost all age groups except for the oldest patients. In ischaemic stroke, thrombolytic therapy raised from 0 to 8.8% in 2015, along with significant trends of decreasing 30-day (from 20 to 16%) and 12-month (from 35 to 31%) case fatality. In haemorrhagic stroke, case fatality had not changed. After ischaemic stroke, 12-month readmissions due to AS declined from 11–12% in 2006–2009 to 9% in 2010–2014. The percentage of patients benefiting from rehabilitation increased from 24 to 32%. Conclusions: In a large population of industrial province, we showed recent, positive trends in AS admissions, treatment and 1-year outcomes. Development of stroke unit networks and increase in thrombolytic treatment were at least in part responsible for survival improvement and reduction of recurrence of AS. However, case-fatality and stroke recurrence remain high compared to those of other developed countries.

Epidemiological analysis of hospitalisations due to recurrent stroke in the Silesian Province, Poland, between 2009 and 2015

“…The in-hospital mortality in patients either with RIS or FIS was significantly higher in cardiogenic stroke compared to atherogenic stroke (Tab. [14][15].…”

“…The first epidemiological data on cerebrovascular diseases in Poland comes from the years 1980-2010 [1][2][3][4][5][6][7][8][9][10][11][12][13]. The most recent studies, both national and regional, were conducted in the last decade [14][15][16][17]. Some of them have concerned the Silesian Province, an industrial region of Poland covering 12% of the nation's population (4.6 million people).…”

Differences in acute ischaemic stroke care in Poland: analysis of claims database of National Health Fund in 2017

“…Over the last decade, the standard of stroke care in Poland has markedly improved, mainly due to the development of a network of stroke units. Most recent studies, both national and regional, have reported decreasing early and late fatality rates as well as lower admission rates, not only for first-ever but also recurrent strokes [14,16,17].…”

Cardiovascular Diseases and Drug Treatment in Patients with the History of Cerebral Stroke: Data of the Outpatient Registry REGION

“…Однако реальная клиническая практика лишь в малой степени соответствует тому, что сформулировано в клинических рекомендациях [10][11][12][13][14][15].…”