Temporal trends in case fatality, discharge destination, and admission to long-term care after acute stroke

Objective:  To determine contemporary trends in case fatality, discharge destination, and admission to long-term care after acute ischemic stroke and intracerebral hemorrhage (ICH) in a large, population-based cohort.

Methods: We used linked administrative data to identify all emergency department visits and hospital admissions for first-ever ischemic stroke or ICH in Ontario, Canada from 2003-2017.  We calculated crude and age/sex-standardized risk of death at 30 days and 1 year from stroke onset.  We stratified crude trends by stroke type, age, and sex and used the Kendall τ-b correlation coefficient to evaluate the significance of trends.  We determined trends in discharge home and to rehabilitation, and admission to long-term care at 1 year. We used Cox proportional hazard and logistic regression models to assess whether trends in outcomes persisted after adjustment for baseline factors, estimated stroke severity, and use of life-sustaining care. 

Results: There were 163,574 p...