Curaçao Stroke Questionnaire Izzy Gerstenbluth Norédiz Lourents November 12, 2010.

CuraçaoStroke Questionnaire

Izzy Gerstenbluth

Norédiz Lourents

November 12, 2010

CSQ 12 Nov, 2010; Gerstenbluth/Lourents

Curaçao: Area & density

Area: 444 km²

Population Density per km²: 319


Curaçao: population Population: circa 145.000

0-19 39.000 20-59 81.000 60+ 25.000 (17.4%)

Live births: ± 2000/ yr Deaths: ± 1000 -1200/yr

Life expectancy at Birth: ♀ 80.1 ♂ 72.4


Intramural care facilities

Hospitals: St. Elisabeth (± 350 beds) Adventist Hospital (± 75 beds) Taams Kliniek (± 75 beds) Capriles Kliniek – psychiatric hospital

nursing home: Bethesda (± 160 beds) Geriatric homes (± 750 beds) Rehabilitation Clinic (Verriet Institute)


Objectives

Measure BOD for common RF Planning (Stroke Unit) Quality of care (Interventions/protocols/

collaboration between health care providers)

Needs assessment Trends over time Research issues


Set-up

STEP-1 STEP-2 ? Hospital/clinician based (Specialists &

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: May 1st- Nov 11th, 2010

133 strokes reported (73 males and 60 females) 123 were discharged and have filled out

Questionnaires; including 21 deceased Questionnaires of 10 patients (5 males and 5

females) are still pending in different wards of the Sint Elisabeth Hospital

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.


Number of strokes reported 1 May –11 Nov. 2010(n=123)

0

5

10

15

20

25

May June July Aug Sept Oct Nov

female

male


Age distribution and gender for strokes recorded in May-Nov. 2010* (n=123)

0

5

10

15

20

25

>50 51-55 56-60 61-65 66-70 71-75 76-80 81-85 86-90 90+

female

male

* May 1, 2010 – Nov 11, 2010; 21 persons died of which 6 were female and 15 were male


Deceased patients by sex and age

0

1

2

3

4

5

>50 51-55 56-60 61-65 66-70 71-75 76-80 81-85 86-90 90+

male female


Type and subtypes of stroke Ischemic stroke: 92*

Cardio-embolism (21) large artery atherosclerosis (19) Small vessel occlusion (53) Other subtype (0)

Intracerebral hemorrhage 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


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


Previous stroke

0

5

10

15

20

25

30

35

40

yes, records notseen

yes, records seen no, records seen no, records notseen

insufficient data


Destination at discharge

0

10

20

30

40

50

60

70

80

deceased home elderly home nursing home rehab clinic other hospital unknown


Riskfactors

0

20

40

60

80

100

120

yes no unknown


Medication in hospital and at discharge

In hospital medication

Anticoagulant drugs 36

Antiplatelet drugs 70

Thrombolysis 1

Other medication 48

Medication at discharge

Anticoagulant drugs 26

Antiplatelet drugs 52

Antidiabetic drugs 28

Cholesterol lowering drugs 60

Antihypertensives 79

Other medication 17


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


Modified Rankin scores pre-stroke vs. Modified Rankin scores at discharge

0

10

20

30

40

50

60

70

no symptoms

not significant disable

slight disable

moderate disable, able to walk

moderate disable unable to walk

severe disable

unknown

dead

at dischargepre stroke


Percentage of deaths due to stroke

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

16.0

1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

male

female

total


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 1 1

1994 2 2 2

1995 2 2 2

1996 1 2 2

1997 3 2 2

1998 2 2 2

1999 3 2 3

2000 1 2 2


CSQ-data entry format in MS-Access


Questionnaire

Obesity? WC SES data: problematic 1st stroke in “study period” & subsequent stroke Neuro signs present: broadened: problematic? Subtypes…subdural hematoma…?? TOAST MRA? Timing scanning left out? Vascular RF : cardioembolism/ alcohol?? Discharge questions: sI 16 deleted


Not (yet ) included:

28 day follow-up (PH nurse?) Fatal stroke events in community (Step

2) Non fatal stroke events in community

(Step 3: Reporting from: Geriatric/nursing homes GP’s District nursing ?)

Curaçao Stroke Questionnaire Izzy Gerstenbluth Norédiz Lourents November 12, 2010.

Documents

Transcript of Curaçao Stroke Questionnaire Izzy Gerstenbluth Norédiz Lourents November 12, 2010.