Curaao Stroke Questionnaire Izzy Gerstenbluth Nordiz Lourents November
Curaçao Stroke Questionnaire Izzy Gerstenbluth Norédiz Lourents November 12, 2010 CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Curaçao: Area & density o Area: 444 km² o Population Density per km²: 319 CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Curaçao: population o Population: circa 145. 000 n 0 -19 39. 000 n 20 -59 81. 000 n 60+ 25. 000 (17. 4%) o Live births: ± 2000/ yr o Deaths: ± 1000 -1200/yr o Life expectancy at Birth: n ♀ 80. 1 n ♂ 72. 4 CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Intramural care facilities o Hospitals: n n St. Elisabeth (± 350 beds) Adventist Hospital (± 75 beds) Taams Kliniek (± 75 beds) Capriles Kliniek – psychiatric hospital o nursing home: Bethesda (± 160 beds) o Geriatric homes (± 750 beds) o Rehabilitation Clinic (Verriet Institute) CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Objectives o Measure BOD for common RF o Planning (Stroke Unit) o Quality of care (Interventions/protocols/ collaboration between health care providers) o Needs assessment o Trends over time o Research issues CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Set-up o STEP-1 o STEP-2 ? o Hospital/clinician based (Specialists & o o o Residents) Coordination & data management: ERU Admittance/imprint/pickup 2 -3/wk Questionnaire in list Filled out upon discharge/ p-u 2 -3/wk Check & review : missing data? Feed back meetings (1/month) CSQ 12 Nov, 2010; Gerstenbluth/Lourents
CSQ: May 1 st- Nov 11 th, 2010 o 133 strokes reported (73 males and 60 females) o 123 were discharged and have filled out Questionnaires; including 21 deceased o Questionnaires of 10 patients (5 males and 5 females) are still pending in different wards of the Sint Elisabeth Hospital o Of the admitted patients 79% were admitted the same day or the day after the stroke; 8% were admitted 2 days after the stroke and 6. 4% were admitted more than 3 days after the stroke. 3. 4% had a stroke while in hospital. CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Number of strokes reported 1 May – 11 Nov. 2010 (n=123) CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Age distribution and gender for strokes recorded in May-Nov. 2010* (n=123) * May 1, 2010 – Nov 11, 2010; 21 persons died of which 6 were female and 15 were male CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Deceased patients by sex and age CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Type and subtypes of stroke o Ischemic stroke: n Cardio-embolism n large artery atherosclerosis n Small vessel occlusion n Other subtype o Intracerebral hemorrhage o o 92* (21) (19) (53) (0) 23 Subarachnoid hemorrhage 8 Unspecified type 1 Three (3) patients had also mention of subdural hematoma *1 person had both cardio-embolism and a small vessel occlusion CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Vital status and type of stroke (n=123) Type of stroke Alive Deceased * Ischemic stroke 79 13 Intracerebral hemorrhage 19 4 Subarachnoid hemorrhage 5 3 • One (1) patient died without mention of type of stroke but with mention of subdural hematoma CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Previous stroke CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Destination at discharge CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Riskfactors CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Medication in hospital and at discharge In hospital medication Anticoagulant drugs Antiplatelet drugs Thrombolysis Other medication 36 70 1 48 Medication at discharge Anticoagulant drugs 26 Antiplatelet drugs 52 Antidiabetic drugs 28 Cholesterol lowering drugs 60 Antihypertensives 79 Other medication 17 CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Modified Rankin scale pre stroke and at discharge Modified Rankin scale Pre stroke At Discharge* No symptoms at all 69 14 No significant disability 18 21 Slight disability 13 8 Moderate disability, able to walk 12 15 Moderate disability unable to walk 7 22 Severe disability 2 21 unknown 2 1 *21 patients died CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Modified Rankin scores pre-stroke vs. Modified Rankin scores at discharge CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Percentage of deaths due to stroke CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Stroke Mortality Year Position ♂ Position ♀ Total 1988 1 2 1 1989 2 2 2 1990 2 1 1 1991 2 1 1 1992 2 1 1 1993 1 1994 2 2 2 1995 2 2 2 1996 1 2 2 1997 3 2 2 1998 2 2 2 1999 3 2000 1 2 2 CSQ 12 Nov, 2010; Gerstenbluth/Lourents
CSQ-data entry format in MS-Access CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Questionnaire o Obesity? WC o SES data: problematic o 1 st stroke in “study period” & subsequent stroke o Neuro signs present: broadened: problematic? o Subtypes…subdural hematoma…? ? o TOAST o MRA? o Timing scanning left out? o Vascular RF : cardioembolism/ alcohol? ? o Discharge questions: s. I 16 deleted CSQ 12 Nov, 2010; Gerstenbluth/Lourents
Not (yet ) included: o 28 day follow-up (PH nurse? ) o Fatal stroke events in community (Step 2) o Non fatal stroke events in community (Step 3: Reporting from: n n n Geriatric/nursing homes GP’s District nursing ? ) CSQ 12 Nov, 2010; Gerstenbluth/Lourents
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