Abstract
Background
With the aging of the population in Taiwan, the financial burden of stroke on the
healthcare system is expected to rise. We aimed to investigate the trends in vascular
risk factors, adherence to stroke performance measures, and stroke outcomes based
on a nationwide representative sample.
Methods
Adult patients hospitalized for first-ever ischemic stroke between 2000 and 2012 were
identified from a nationwide administrative database. The study period was divided
into 1-year intervals. The Cuzick test and the Cochran-Armitage test were used to
determine the significance of changes over time. Trends in stroke outcomes as a function
of year were assessed using logistic regression, controlling for age, sex, comorbidity,
and stroke severity.
Results
A total of 11,462 patients (mean age 67.3 years, female 40.9%) were hospitalized. Between 2000 and 2012, the prevalence of hypertension,
diabetes mellitus, hyperlipidemia, and atrial fibrillation increased while the prevalence
of coronary artery disease decreased. The proportion of patients taking antihypertensive
or antidiabetic medication prior to stroke decreased, whereas the proportion of patients
taking lipid lowering medication increased. Adherence to the five selected performance
measures significantly improved. A significant decreasing trend in the proportion
of recurrent stroke or all-cause death within one year was observed regardless of
whether adjustment for age, sex, comorbidity, and stroke severity was made.
Conclusions
Despite the rising prevalence of vascular risk factors, improved adherence to stroke
performance measures was accompanied by better stroke outcomes.
Keywords
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Article info
Publication history
Published online: May 02, 2017
Accepted:
May 1,
2017
Received:
March 17,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
