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Adverse outcome after incident stroke hospitalization for Indigenous and non-Indigenous Australians in the Northern Territory

He, Vincent Y. F., Condon, John R., You, Jiqiong, Zhao, Yuejen and Burrow, James N. C. (2015). Adverse outcome after incident stroke hospitalization for Indigenous and non-Indigenous Australians in the Northern Territory. International Journal of Stroke,10(A100):89-95.

Document type: Journal Article
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IRMA ID 81144320xPUB104
Title Adverse outcome after incident stroke hospitalization for Indigenous and non-Indigenous Australians in the Northern Territory
Author He, Vincent Y. F.
Condon, John R.
You, Jiqiong
Zhao, Yuejen
Burrow, James N. C.
Journal Name International Journal of Stroke
Publication Date 2015
Volume Number 10
Issue Number A100
ISSN 1747-4930   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84946410086
Start Page 89
End Page 95
Total Pages 7
Place of Publication United Kingdom
Publisher Sage Publications Ltd.
Field of Research 111701 - Aboriginal and Torres Strait Islander Health
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
Survival after a stroke is lower for Indigenous than other stroke patients in Australia. It is not known whether recurrence is more common for Indigenous patients, or whether their higher prevalence of comorbidity affects their lower survival.

Aims
This study aimed to investigate the stroke recurrence and role of comorbidities in adverse stroke outcomes (recurrence and death) for Indigenous compared with other Australians.

Methods
A retrospective cohort study of first hospitalization for stroke (n = 2105) recorded in Northern Territory hospital inpatient data between 1996 and 2011 was conducted. For the multivariable analyses of adverse outcomes, logistic regression was used for case fatality and competing risk analysis for recurrent stroke and long-term death. Comorbidities (identified from inpatient diagnosis data) were analyzed using the Charlson Comorbidity Index (modified for stroke outcomes).

Results
Prevalence of comorbidities, case fatality, incidence of re-hospitalization for recurrent stroke, and long-term death rate were higher for Indigenous than non-Indigenous stroke patients. Adjustment for comorbidity in multivariable analyses considerably reduced Indigenous patients' excess risk for case fatality (odds ratio: 1·25, 0·88–1·78) and long-term death (standard hazard ratio: 1·27, 1·01–1·61) (but not recurrence), implying that their excess risk of death was in part due to higher comorbidity prevalence.

Conclusion
Indigenous stroke patients have higher prevalence of comorbidities than non-Indigenous stroke patients, which explained part of the disparity in both case fatality and long-term survival but did not explain the disparity in stroke recurrence at all.
DOI http://dx.doi.org/10.1111/ijs.12600   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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