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ISSN: 2329-8847

Journal of Aging Science
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Research Article

Relationship between Hemorrhagic Stroke and Mortality in Chronic Complex Outpatients: Results from a Community Cohort of Patients

González-Henares MA1,2, Clua-Espuny JL2,3*, Queralt-Tomas MLL4, Campo-Tamayo W5, Muria-Subirats E5, Panisello-Tafalla A6, Lucas-Noll J7, Forcadell-Arenas T8 and Gil-Guillen VF9

1EAP-Camarles-Aldea-Ampolla, Catalonian Health Institute, SAP Terres de l’Ebre, Health Department, Generalitat de Catalunya, CAP Ampolla, 43895 Tortosa, Spain

2Department of Research, ICS Terres de l’Ebre, Research Institute University Primary Care (IDIAP) Jordi Gol, Spain

3EAP Tortosa 1-Est, Catalonian Health Institute, SAP Terres de l’Ebre, Health Department, Generalitat de Catalunya, CAP Temple, 43500 Tortosa, Spain

4EAP Tortosa-2-Oest, SAP Terres de l’Ebre, Health Department, Generalitat de Catalunya, Catalonian Health Institute, CAP Xerta, 43592 Spain

5UUDD Tortosa-Terres de l’Ebre, Resident Medicina Familiary Comunitaria, CAP Temple, EAP Tortosa Est, Institut Català de la Salut. Tortosa 43500, Spain

6EAP-Camarles-Aldea-Ampolla, Catalonian Health Institute, SAP Terres de l’Ebre, Health Department, Generalitat de Catalunya, CAP Camarles, 43894 Tortosa, Spain

7EAP-Alcanar-St Carlos de la Rápita, Catalonian Health Institute, SAP Terres de l’Ebre, Health Department, Generalitat de Catalunya, CAP St Carles de la Rápita, 43894 Tortosa, Spain

8EAP Tortosa 1-Est, Catalonian Health Institute, SAP Terres de l’Ebre, Health Department, Generalitat de Catalunya, CAP Temple, 43500 Tortosa, Spain

9Cátedra Medicina de Familia, Universidad Miguel Hernández, 03202 Elche, Spain

*Corresponding Author:
Clua-Espuny JL
EAP-Tortosa Est, Institut Català Salut, SAP Terres de l’Ebre
Health Department, Generalitat de Catalunya, Plaça Carrilet
s/núm Tortosa 43500 Spain, Spain
Tel: +(34)-977 510018
Fax: +(34)-977445728
E-mail: [email protected]

Received date: April 22, 2017; Accepted date: May 15, 2017; Published date: May 17, 2017

Citation: González-Henares MA, Clua-Espuny JL, Queralt-Tomas MLL, Campo-Tamayo W, Muria-Subirats E, et al. (2017) Relationship between Hemorrhagic Stroke and Mortality in Chronic Complex Outpatients: Results from a Community Cohort of Patients. J Aging Sci 5:180. doi:10.4172/2329-8847.1000180

Copyright: © 2017 González-Henares MA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Question: Around 3-5% of people can be identified as chronic complex patients(CCP) and are increasingly at risk of hemorrhagic stroke.The main objective was to explore differences in risk factors and the association with outcome factors on mortality.

Materials and Methods: Multicenter and prospective cohort study from January 1 2013 to September 30 2016 among patients registered as chronic complex outpatients. To predict hazard ratios, mean survival time, and survival probabilities, multivariate Cox regression was used.

Results: 932 CCP were included (52.3% women). Average age was 82.5 years (95% CI 81.8-83.2). During a mean follow-up period of 2.8 years, 65 (6.98%) stroke episodes happened (37 (56.9%) ischemic; 28 (43.1%) hemorrhagic). The percentage of ICH almost doubled (21.0% to 43.1) after CCP diagnosis; 26.1% had polypharmacy (≥ 10), 57.6% VKA-treated patientsshowed TTR <60%, and had a higher incidence of falling (31.9% vs. 19.2%, p 0.002).The average survival time was significantly shorter associated with age (HR 1.03 95% CI 1.14-1.53, p 0.001), previous stroke (HR 13.54 95%, CI 9.23-19.81, p<0.001), antiagreggant treatment (HR 1.97 95% CI 1.21-3.21, p 0.006), anticoagulant treatment (HR 1.78 95%, CI 1.22-2.60, p 0.002), and Barthel score <60 (HR 1.43 95% CI 1.04-1.97, p 0.024).

Conclusions: Given the co-occurrence of hemorrhagic strokes with poor performance status, multi-morbidity, and polypharmacy, multi-dimensional interventions are needed to improve health outcomes.

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