Utilisation of diagnostic computerised tomography imaging and immediate clinical outcomes in older people with stroke before and after introduction of the National Service Framework for older people. A comparative study of hospital-based stroke registry data (1997-2003)

Norfolk experience

Phyo K Myint, Sarah L Vowler, Oliver Redmayne, Robert A Fulcher

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

INTRODUCTION: how the National Service Framework (NSF) for older people in England might be associated with changes in clinically relevant stroke outcome has not been investigated. We looked for changes in computerised tomography (CT) scan rate, inpatient case-fatality rate (CFR), length of acute hospital stay and discharge destination for older people with stroke, compared with their younger counterparts, for a period before, and after, the introduction of the NSF.

METHODS: two periods, 4 years before and 2 years after the publication of the NSF, were selected to compare the above outcomes between three age categories: < 65, 65-84 and > or = 85 years of age. Annual summary data for these periods were compared for the magnitude of changes in all age categories for all outcomes measured between pre- and post-NSF periods.

RESULTS: n = 5,219. Utilisation of CT imaging had increased in all age groups post-NSF, with the most significant improvement in the oldest group. This change was associated with a greater proportion of people who had CT in this age group being discharged home in the post-NSF period. There was no change in the mortality from stroke in any age group during the study. Although the length of acute hospital stay increased, this was associated with a higher percentage of home discharges particularly in > 65-year olds, suggesting better clinical outcome in those who survived.

CONCLUSIONS: in this single-centre analysis, the post-NSF period appeared to be associated with improvement in outcome in older people with stroke. Continual monitoring using stroke registry data may help to assess whether these effects are sustained in the longer term.

Original languageEnglish
Pages (from-to)399-403
Number of pages5
JournalAge and Ageing
Volume35
Issue number4
DOIs
Publication statusPublished - Jul 2006

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Registries
Stroke
Tomography
Age Groups
Length of Stay
Mortality
England
Publications
Inpatients

Keywords

  • Age Factors
  • Aged
  • Aged, 80 and over
  • England
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prejudice
  • Recovery of Function
  • Registries
  • Retrospective Studies
  • State Medicine
  • Stroke
  • Tomography, X-Ray Computed
  • Treatment Outcome

Cite this

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title = "Utilisation of diagnostic computerised tomography imaging and immediate clinical outcomes in older people with stroke before and after introduction of the National Service Framework for older people. A comparative study of hospital-based stroke registry data (1997-2003): Norfolk experience",
abstract = "INTRODUCTION: how the National Service Framework (NSF) for older people in England might be associated with changes in clinically relevant stroke outcome has not been investigated. We looked for changes in computerised tomography (CT) scan rate, inpatient case-fatality rate (CFR), length of acute hospital stay and discharge destination for older people with stroke, compared with their younger counterparts, for a period before, and after, the introduction of the NSF.METHODS: two periods, 4 years before and 2 years after the publication of the NSF, were selected to compare the above outcomes between three age categories: < 65, 65-84 and > or = 85 years of age. Annual summary data for these periods were compared for the magnitude of changes in all age categories for all outcomes measured between pre- and post-NSF periods.RESULTS: n = 5,219. Utilisation of CT imaging had increased in all age groups post-NSF, with the most significant improvement in the oldest group. This change was associated with a greater proportion of people who had CT in this age group being discharged home in the post-NSF period. There was no change in the mortality from stroke in any age group during the study. Although the length of acute hospital stay increased, this was associated with a higher percentage of home discharges particularly in > 65-year olds, suggesting better clinical outcome in those who survived.CONCLUSIONS: in this single-centre analysis, the post-NSF period appeared to be associated with improvement in outcome in older people with stroke. Continual monitoring using stroke registry data may help to assess whether these effects are sustained in the longer term.",
keywords = "Age Factors, Aged, Aged, 80 and over, England, Female, Humans, Length of Stay, Male, Middle Aged, Multivariate Analysis, Prejudice, Recovery of Function, Registries, Retrospective Studies, State Medicine, Stroke, Tomography, X-Ray Computed, Treatment Outcome",
author = "Myint, {Phyo K} and Vowler, {Sarah L} and Oliver Redmayne and Fulcher, {Robert A}",
year = "2006",
month = "7",
doi = "10.1093/ageing/afl030",
language = "English",
volume = "35",
pages = "399--403",
journal = "Age and Ageing",
issn = "0002-0729",
publisher = "OXFORD UNIV PRESS INC",
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TY - JOUR

T1 - Utilisation of diagnostic computerised tomography imaging and immediate clinical outcomes in older people with stroke before and after introduction of the National Service Framework for older people. A comparative study of hospital-based stroke registry data (1997-2003)

T2 - Norfolk experience

AU - Myint, Phyo K

AU - Vowler, Sarah L

AU - Redmayne, Oliver

AU - Fulcher, Robert A

PY - 2006/7

Y1 - 2006/7

N2 - INTRODUCTION: how the National Service Framework (NSF) for older people in England might be associated with changes in clinically relevant stroke outcome has not been investigated. We looked for changes in computerised tomography (CT) scan rate, inpatient case-fatality rate (CFR), length of acute hospital stay and discharge destination for older people with stroke, compared with their younger counterparts, for a period before, and after, the introduction of the NSF.METHODS: two periods, 4 years before and 2 years after the publication of the NSF, were selected to compare the above outcomes between three age categories: < 65, 65-84 and > or = 85 years of age. Annual summary data for these periods were compared for the magnitude of changes in all age categories for all outcomes measured between pre- and post-NSF periods.RESULTS: n = 5,219. Utilisation of CT imaging had increased in all age groups post-NSF, with the most significant improvement in the oldest group. This change was associated with a greater proportion of people who had CT in this age group being discharged home in the post-NSF period. There was no change in the mortality from stroke in any age group during the study. Although the length of acute hospital stay increased, this was associated with a higher percentage of home discharges particularly in > 65-year olds, suggesting better clinical outcome in those who survived.CONCLUSIONS: in this single-centre analysis, the post-NSF period appeared to be associated with improvement in outcome in older people with stroke. Continual monitoring using stroke registry data may help to assess whether these effects are sustained in the longer term.

AB - INTRODUCTION: how the National Service Framework (NSF) for older people in England might be associated with changes in clinically relevant stroke outcome has not been investigated. We looked for changes in computerised tomography (CT) scan rate, inpatient case-fatality rate (CFR), length of acute hospital stay and discharge destination for older people with stroke, compared with their younger counterparts, for a period before, and after, the introduction of the NSF.METHODS: two periods, 4 years before and 2 years after the publication of the NSF, were selected to compare the above outcomes between three age categories: < 65, 65-84 and > or = 85 years of age. Annual summary data for these periods were compared for the magnitude of changes in all age categories for all outcomes measured between pre- and post-NSF periods.RESULTS: n = 5,219. Utilisation of CT imaging had increased in all age groups post-NSF, with the most significant improvement in the oldest group. This change was associated with a greater proportion of people who had CT in this age group being discharged home in the post-NSF period. There was no change in the mortality from stroke in any age group during the study. Although the length of acute hospital stay increased, this was associated with a higher percentage of home discharges particularly in > 65-year olds, suggesting better clinical outcome in those who survived.CONCLUSIONS: in this single-centre analysis, the post-NSF period appeared to be associated with improvement in outcome in older people with stroke. Continual monitoring using stroke registry data may help to assess whether these effects are sustained in the longer term.

KW - Age Factors

KW - Aged

KW - Aged, 80 and over

KW - England

KW - Female

KW - Humans

KW - Length of Stay

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Prejudice

KW - Recovery of Function

KW - Registries

KW - Retrospective Studies

KW - State Medicine

KW - Stroke

KW - Tomography, X-Ray Computed

KW - Treatment Outcome

U2 - 10.1093/ageing/afl030

DO - 10.1093/ageing/afl030

M3 - Article

VL - 35

SP - 399

EP - 403

JO - Age and Ageing

JF - Age and Ageing

SN - 0002-0729

IS - 4

ER -