de Peretti Christine, Nicolau Javier, Tuppin Philippe, Schnitzler Alexis, Woimant France
Institut de veille sanitaire, 94415 Saint-Maurice cedex, France.
Presse Med. 2012 May;41(5):491-503. doi: 10.1016/j.lpm.2012.01.032. Epub 2012 Mar 6.
The objectives of this study were to assess the main characteristics of acute and post-acute care for transient ischemic attack (TIA) and stroke, based on the French national hospitalization databases and their evolutions from 2007 through 2009.
Hospitalizations with a main diagnosis of stroke were first selected in the 2007, 2008 and 2009 French hospital discharge databases (PMSI-MCO). They were then linked in the corresponding national databases of post-acute hospitalization records (PA), through the common anonymous patient number used in every hospitalization database.
In France, 138,601 acute hospitalizations were registered in 2009, 31,674 TIA and 106,927 strokes, of which 91% were in public hospitals. The mean length of stay was 6.4 days for TIA and 12.7 days for stroke. Stroke hospitalization in stroke unit increased from 9.7% in 2007 to 25.9% in 2009 and acute care in hospital having a stroke unit, from 22.9% to 47.4%. A third of stroke patients hospitalized in acute care in 2009 (and not deceased), were linked in the post-acute-care database: 10.4% were in rehabilitations facilities (RF) and 23.4%, in post-acute nursing facilities (PAN), versus respectively 7.5% and 24% in 2007.
French national hospitalization databases are exhaustive (acute care) or quasi-exhaustive (post-acute care) and can be linked with a good reliability. However, their validity depends on coding accuracy. In this respect, stroke unit hospitalization might be underreported.
The French national hospital databases showed consistent improvements in stroke care in recent years. At the acute phase, there was an increase in stroke care in both stroke unit and hospital with stroke unit, due to the development of stroke care in France. Furthermore, the proportion of stroke patient discharged in rehabilitation facilities increased from 7.5% to 10.4%.
本研究的目的是基于法国国家住院数据库及其2007年至2009年的演变情况，评估短暂性脑缺血发作（TIA）和中风的急性及急性后期护理的主要特征。
首先在2007年、2008年和2009年的法国医院出院数据库（PMSI-MCO）中选择主要诊断为中风的住院病例。然后通过每个住院数据库中使用的通用匿名患者编号，将它们与相应的国家急性后期住院记录数据库（PA）进行关联。
在法国，2009年登记了138,601例急性住院病例，其中31,674例为TIA，106,927例为中风，其中91%在公立医院。TIA的平均住院时间为6.4天，中风为12.7天。中风单元的中风住院率从2007年的9.7%增加到2009年的25.9%，设有中风单元的医院的急性护理率从22.9%增加到47.4%。2009年在急性护理中住院的中风患者（未死亡）中有三分之一与急性后期护理数据库相关联：10.4%在康复设施（RF）中，23.4%在急性后期护理机构（PAN）中，而2007年分别为7.5%和24%。
法国国家住院数据库详尽（急性护理）或近乎详尽（急性后期护理），并且可以可靠地关联。然而，它们的有效性取决于编码准确性。在这方面，中风单元住院可能报告不足。
法国国家医院数据库显示近年来中风护理有持续改善。在急性期，由于法国中风护理的发展，中风单元和设有中风单元的医院的中风护理均有所增加。此外，出院后进入康复设施的中风患者比例从7.5%增加到10.4%。
