Sande Ingvild Svorkdal, Helgheim Kamilla Lind, Saltvedt Ingvild, Røsstad Tove Garåsen, Spigset Olav, Ellekjær Hanne, Gynnild Mari Nordbø
Department of Circulation and Medical Imaging, Faculty of Medicine and Health Science, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.
Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.
Int J Gen Med. 2025 Apr 15;18:2141-2150. doi: 10.2147/IJGM.S508154. eCollection 2025.
There is limited information on follow-up routines for adequate poststroke care after discharge from hospital.
This study aimed to assess the likelihood of general practitioner (GP) follow-up within 18 months after an ischemic stroke and to identify clinical factors influencing follow-up frequency.
Home-dwelling patients admitted to St. Olavs University Hospital with ischemic stroke between 2015 and 2017 were included. Follow-up was assessed by linkage to administrative health data, tracking GP visits over the 18-month period post discharge.
In total, 278 of the 302 patients included (92%) had at least one consultation, with a mean time to first consultation of 64 days (SD 96). Of these 278 patients, the cumulative probability of a consultation within 30, 90, 365, and 540 days was 56%, 81%, 96%, and 100%, respectively. The mean number of consultations during the 18-month follow-up was 6.2 (SD 6.7). Factors associated with a lower probability of consultation within the first 90 days included use of home care services (HR 0.56, 95% CI 0.41-0.77), disability (HR 0.70, 95% CI 0.61-0.79), frailty (HR 0.82, 95% CI 0.72-0.94), and cognitive impairment (HR 0.85, 95% CI 0.75-0.97). Additionally, older age (coefficient -0.09 per year, 95% CI -0.16 to -0.02), use of home care services (coefficient -2.34, 95% CI -4.52 to -0.15), and cognitive impairment (coefficient -0.77, 95% CI -1.46 to -0.09) were associated with fewer consultations.
Most patients had at least one GP consultation within 18 months poststroke. However, vulnerable patients with advanced age, frailty, disability, and cognitive impairment may be at risk of suboptimal follow-up after ischemic stroke.
关于出院后中风后充分护理的随访常规信息有限。
本研究旨在评估缺血性中风后18个月内全科医生(GP)随访的可能性,并确定影响随访频率的临床因素。
纳入2015年至2017年间入住圣奥拉夫大学医院的缺血性中风居家患者。通过与行政健康数据链接进行随访,追踪出院后18个月内的全科医生就诊情况。
总共纳入的302例患者中,278例(92%)至少进行了一次会诊,首次会诊的平均时间为64天(标准差96天)。在这278例患者中,30天、90天、365天和540天内会诊的累积概率分别为56%、81%、96%和100%。18个月随访期间的平均会诊次数为6.2次(标准差6.7次)。与前90天内会诊概率较低相关的因素包括使用家庭护理服务(风险比0.56,95%置信区间0.41 - 0.77)、残疾(风险比0.70,95%置信区间0.61 - 0.79)、虚弱(风险比0.82,95%置信区间0.72 - 0.94)和认知障碍(风险比0.85,95%置信区间0.75 - 0.97)。此外,年龄较大(每年系数 -0.09,95%置信区间 -0.16至 -0.02)、使用家庭护理服务(系数 -2.34,95%置信区间 -4.52至 -0.15)和认知障碍(系数 -0.77,95%置信区间 -1.46至 -0.09)与会诊次数较少相关。
大多数患者在中风后18个月内至少进行了一次全科医生会诊。然而,年龄较大、虚弱、残疾和有认知障碍的脆弱患者在缺血性中风后可能面临随访不足的风险。