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Asplund, K.; Ashburner, S.; Cargill, K.; Hux, M.; Lees, K.; Drummond, M. (2003)
Languages: English
Types: Article
Background and Purpose: Outcome in patients hospitalized for acute stroke varies considerably between populations. Within the framework of the GAIN International trial, a large multicenter trial of a neuroprotective agent (gavestinel, glycine antagonist), stroke outcome in relation to health care resource use has been compared in a large number of countries, allowing for differences in case mix. Methods: This substudy includes 1,422 patients in 19 countries grouped into 10 regions. Data on prognostic variables on admission to hospital, resource use, and outcome were analyzed by regression models. Results: All results were adjusted for differences in prognostic factors on admission (NIH Stroke Scale, age, comorbidity). There were threefold variations in the average number of days in hospital/institutional care (from 20 to 60 days). The proportion of patients who met with professional rehabilitation staff also varied greatly. Three-month case fatality ranged from 11% to 28%, and mean Barthel ADL score at three months varied between 64 and 73. There was no relationship between health care resource use and outcome in terms of survival and ADL function at three months. The proportion of patients living at home at three months did not show any relationship to ADL function across countries. Conclusions: There are wide variations in health care resource use between countries, unexplained by differences in case mix. Across countries, there is no obvious relationship between resource use and clinical outcome after stroke. Differences in health care traditions (treatment pathways) and social We thank the coinvestigators and research staff at the participating centers for their support. Glaxo Wellcome sponsored the GAIN International trial, supported the present analyses and reviewed the final draft of the article.
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    • 1. Brainin M, Bornstein N, Boysen G, Demarin V. Acute neurological stroke care in Europe: results of the European Stroke Care Inventory. Eur J Neurol. 2000;7:5-10.
    • 2. Britton M, Andersson A. Home rehabilitation after stroke. Reviewing the scientific evidence on effects and costs. Int J Technol Assess Health Care. 2000;16:842-848.
    • 3. Caro JJ, Huybrechts KF, Duchesne I, for the Stroke Economic Analysis Group. Management patterns and costs of acute ischemic stroke: an international study. Stroke. 2000;31:582-590.
    • 4. Caro JJ, Huybrechts KF, Kelley HE. Predicting treatment costs after acute ischemic stroke on the basis of patient characteristics at presentation and early dysfunction. Stroke. 2001;32:100-106.
    • 5. Drummond MF, Ward GH. The financial burden of stroke and the economic evaluation of treatment alternatives. In: Rose FC, ed. Stroke: Epidemiological, therapeutic and socio-economic aspects. London: Royal College of Medicine Services International Congress and Symposium Series, vol. 99. 1986.
    • 6. Ebrahim S, Holloway RG, Benesch CG. Systematic review of cost-effectiveness research of stroke evaluation and treatment. Stroke. 1999;30:2759-2768.
    • 7. Evers SM, Ament AJ, Blaauw G. Economic evaluation in stroke research: Aa systematic review. Stroke. 2000;31:1046-1053.
    • 8. Gorelick PB. Neuroprotection in acute ischaemic stroke: A tale of for whom the bell tolls? Lancet. 2000;355:1925-1926.
    • 9. Grieve R, Porsdal V, Hutton J, Wolfe C. A comparison of the cost-effectiveness of stroke care provided in London and Copenhagen. Int J Technol Assess Health Care. 2000;16:684-695.
    • 10. Jorgensen HS, Nakayama H, Pedersen PM, et al. Epidemiology of stroke-related disability. Patient characteristics and primary outcomes of patients with stroke from Copenhagen Stroke Study. Clin Geriatr Med. 1999;15:785-799.
    • 11. Langhorne P, Dennis M. Stroke units: An evidence based approach. London: BMJ Books; 1998.
    • 12. Lees K, Asplund K, Carolei A, et al. Glycine antagonist (gavestinel) in neuroprotection (GAIN International) in patients with acute stroke: A randomised controlled trial. GAIN International Investigators. Lancet. 2000;355:1949-1954.
    • 13. Mahoney FJ, Barthel DW. Functional evaluation: The Barthel Index. Md State Med J. 1965;14:61- 65.
    • 14. Murray CJL, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997;349:1436-1442.
    • 15. Murray CJL, Lopez ADE, eds. The global burden of disease. Geneva: World Health Organization; 1996.
    • 16. OECD Health Data 2000. Comparative analysis of 29 countries. Available at http://www.oecd. org./els/health.
    • 17. Peltonen M, Rose´n M, Lundberg V, Asplund K. Social patterning of myocardial infarction and stroke in Sweden: Incidence and survival. Am J Epidemiol. 2000;151:283-292.
    • 18. Petty GW, Brown RDJ, Whisnant JP, et al. Ischemic stroke subtypes: A population-based study of incidence and risk factors. Stroke. 1999;30:2513-2516.
    • 19. Tanizaki Y, Kiyohara Y, Kato I, et al. Incidence and risk factors for subtypes of cerebral infarction in a general population: The Hisayama Study. Stroke. 2000;31:2616-2622.
    • 20. Tere´nt A, Marke´ L-A❛ , Asplund K, et al. Costs of stroke in Sweden. A national perspective. Stroke. 1994;25:2363-2369.
    • 21. Weir NU, Sandercock PAG, Lewis SC, Signori DF, Warlow CP, on behalf of the IST Collaborative Group. Variations between countries in outcome after stroke in the International Strokle Trial (IST). Stroke. 2001;32:1370-1377.
    • 22. Asplund K, Rajakangas A-M, Kuulasmaa K, et al. Multinational comparison of diagnostic procedures and management of acute stroke. The WHO MONICA Study. Cerebrovasc Dis. 1996;6: 66-74.
    • 23. Thorvaldsen P, Asplund K, Kuulasmaa K, Rajakangas A-M, Schroll M. Stroke incidence, case fatality, and mortality. The WHO MONICA Project. Stroke. 1995;26:361-367.
    • 24. Wolfe CD, Giroud M, Kolominsky-Rabas P, et al. Variations in stroke incidence and survival in 3 areas of Europe. European Registries of Stroke (EROS) Collaboration. Stroke. 2000;31:2074- 2079.
    • 25. Wolfe CD, Tilling K, Beech R, Rudd AG. Variations in case fatality and dependency from stroke in western and central Europe. The European BIOMED Study of Stroke Care Group. Stroke. 1999;30:350-356.
    • 26. Zethraeus N, Molin T, Henriksson P, J o¨nsson B. Costs of coronary heart disease and stroke: The case of Sweden. J Intern Med. 1999;246:151-160.
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