Stroke in the young: access to care and outcome; a Western versus eastern European perspective

J Stroke Cerebrovasc Dis. Nov-Dec 2008;17(6):360-5. doi: 10.1016/j.jstrokecerebrovasdis.2008.04.002.

Abstract

Background: To develop effective strategies to address the needs of young patients with stroke, it is important to recognize what components of stroke care they receive. The aims of this study were to describe the provision of stroke care and the factors associated with 3-month mortality and disability (Barthel Index 0-14) in patients younger than 55 years across Western and Eastern Europe.

Methods: Data from hospital-based stroke registers in Western Europe (7 centers, 6 countries) and Eastern Europe (4 centers, 3 countries) were analyzed.

Results: Of 1735 patients admitted to hospital, 201 (11.5%) patients were younger than 55 years (Western European centers 51%, and Eastern European centers 49%). Stroke department care was higher in Western centers (67%) than in Eastern centers (24%) (P < .001). Doctor (P < .001), therapy (P = .01), and nursing (P < .001) time were higher in Western centers. At 3 months, case fatalities between Western and Eastern centers were 8% versus 23% (P = .003). Patients in Eastern European centers were more likely to have disability at 3 months (odds ratio = 24.3, confidence interval = 1.2-494, P = .04).

Conclusion: Young patients with stroke in Western Europe are more likely to gain access to a number of components of stroke care compared with those in Eastern Europe. The future challenge is to ensure that recommendations are adopted to ensure all young patients receive evidence-based stroke care across Europe.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Distribution
  • Age Factors
  • Emergency Medical Services / economics
  • Emergency Medical Services / statistics & numerical data*
  • Emergency Medical Services / trends
  • Europe / epidemiology
  • Europe, Eastern / epidemiology
  • Female
  • Health Policy / trends
  • Health Services Accessibility / standards
  • Health Services Accessibility / statistics & numerical data
  • Health Services Accessibility / trends*
  • Hospitalization / statistics & numerical data
  • Hospitalization / trends
  • Humans
  • Male
  • Middle Aged
  • Mortality / trends
  • Outcome Assessment, Health Care / methods
  • Quality of Health Care / economics
  • Quality of Health Care / standards
  • Quality of Health Care / statistics & numerical data
  • Registries
  • Stroke / economics
  • Stroke / mortality*
  • Stroke / therapy*
  • Treatment Outcome
  • Young Adult