Risk-adjusted hospital mortality rates for stroke: evidence from the Australian Stroke Clinical Registry (AuSCR)

Dominique A Cadilhac; Monique F Kilkenny; Christopher R Levi; Natasha A Lannin; Amanda G Thrift; Joosup Kim; Brenda Grabsch; Leonid Churilov; Helen M Dewey; Kelvin Hill; Steven G Faux; Rohan Grimley; Helen Castley; Peter J Hand; Andrew Wong; Geoffrey K Herkes; Melissa Gill; Douglas Crompton; Sandy Middleton; Geoffrey A Donnan; Craig S Anderson

Journal article

Risk-adjusted hospital mortality rates for stroke: evidence from the Australian Stroke Clinical Registry (AuSCR)

Dominique A Cadilhac, Monique F Kilkenny, Christopher R Levi, Natasha A Lannin, Amanda G Thrift, Joosup Kim, Brenda Grabsch, Leonid Churilov, Helen M Dewey, Kelvin Hill, Steven G Faux, Rohan Grimley, Helen Castley, Peter J Hand, Andrew Wong, Geoffrey K Herkes, Melissa Gill, Douglas Crompton, Sandy Middleton, Geoffrey A Donnan Show all

MEDICAL JOURNAL OF AUSTRALIA | AUSTRALASIAN MED PUBL CO LTD | Published : 2017

DOI: 10.5694/mja16.00525

Abstract

OBJECTIVES: Hospital data used to assess regional variability in disease management and outcomes, including mortality, lack information on disease severity. We describe variance between hospitals in 30-day risk-adjusted mortality rates (RAMRs) for stroke, comparing models that include or exclude stroke severity as a covariate. DESIGN: Cohort design linking Australian Stroke Clinical Registry data with national death registrations. Multivariable models using recommended statistical methods for calculating 30-day RAMRs for hospitals, adjusted for demographic factors, ability to walk on admission, stroke type, and stroke recurrence. SETTING: Australian hospitals providing at least 200 episodes ..

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University of Melbourne Researchers

Helen Dewey Author Medicine - Austin Health

Peter Hand Author Medicine - Royal Melbourne Hospital

Geoffrey Donnan Author Medicine - Royal Melbourne Hospital

Douglas Crompton Author Medical Education

Dominique Cadilhac Author Medicine - Austin Health

Related Projects (1)

STROKE 123:A COLLABORATIVE NATIONAL EFFORT TO MONITOR PROMOTE AND IMPROVE THE QUALITY OF STROKE CARE IN HOSPITALS AND PATIENT OUTCOMES

Stroke is a major public health issue in Australia. This Better Health Initiative partnership project is designed to rigorously evaluate a m..

Grants

Awarded by National Health and Medical Research Council (NHMRC)

Awarded by NHMRC

Awarded by NHMRC Early Career Fellowship

Awarded by NHMRC Practitioner Fellowship

Awarded by NHMRC Senior Principal Research Fellowship

Funding Acknowledgements

We acknowledge Joyce Lim and other staff from the George Institute for Global Health who contributed to establishing AuSCR. We also acknowledge staff from the Florey Institute of Neuroscience and Mental Health, including Karen Moss, Enna Salama, Kate Paice, Kasey Wallis, Adele Gibbs and Alison Dias from AuSCR Office, who contributed to AuSCR operations during this study period. Staff from the Stroke Foundation are acknowledged for their contributions to patient follow-up. We also thank the hospital staff for their diligence in collecting data for AuSCR, and hospital site investigators who provided data between 2010 and 2014. Dominique Cadilhac was supported by a fellowship from the National Health and Medical Research Council (NHMRC; 1063761; co-funded by the Heart Foundation), Amanda Thrift by an NHMRC fellowship (1042600), and Monique Kilkenny by an NHMRC Early Career Fellowship (1109426); Christopher Levi holds an NHMRC Practitioner Fellowship (1043913) and Craig Anderson an NHMRC Senior Principal Research Fellowship (1081356). AuSCR was supported by grants from the NHMRC (1034415), Allergan, Ipsen, Boehringer-Ingelheim, Monash University, Queensland Health, and the Stroke Foundation.