Home-Time Is a Feasible and Valid Stroke Outcome Measure in National Datasets. Issue 5 (May 2019)

• Record Type: Journal Article
• Authors: McDermid, Iain; Barber, Mark; Dennis, Martin; Langhorne, Peter; Macleod, Mary J.; McAlpine, Christine H.; Quinn, Terence J.
• Is Part Of: Stroke. Volume 50:Issue 5(2019)
• Publication Date: 2019-05
• Subjects: length of stay -- quality improvement -- morbidity -- stroke -- survivors; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.118.023916
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : Background and Purpose—: Home-time (HT) is a stroke outcome measure based on time spent at home after stroke. We hypothesized that HT assessment would be feasible and valid using national data. Methods—: We linked the Scottish Stroke Care Audit to routine healthcare data and calculated 90-day HT for all strokes, 2005 to 2017. We described prognostic validity (Spearman rank correlation) of HT to baseline factors. Results—: We were able to calculate HT for 101 969 strokes (99.3% of total Scottish strokes). Mean HT was 46 days (95% CI, 45.8–46.2; range, 0–90). HT showed consistent correlation with our prespecified prognostic factors: age: ρ, −0.35 (95% CI, −0.35 to −0.36); National Institutes of Health Stroke Scale score, −0.54 (95% CI, −0.52 to −0.55); and 6 simple variables (ordinal), −0.61 (95% CI, −0.61 to −0.62). Conclusions—: HT can be derived at scale using routine clinical data and appears to be a valid proxy measure of functional recovery. Other national databases could use HT as a time and cost efficient measure of medium and longer-term outcomes. Abstract : Supplemental Digital Content is available in the text.