Article

This study evaluates comorbidities, primary and secondary drug
prevention and two years survival among patients hospitalized for stroke during
the first half of 2008. METHODS: First hospitalization with stroke diagnosis was
identified by using the national hospital discharge database and linked to the
reimbursement database of the beneficiaries covered by the general health
insurance scheme (74% of the 64 million population). A medication was considered
to be used when there were more than two reimbursements over the 6 months
following or preceding hospitalization. RESULTS: Among the 36,844 patients with
stroke, 31.6% had a main diagnosis of transient ischemic attack (TIA), 53.6% a
cerebral infarct (CI) and 14.8% a cerebral hemorrhage (CH). For the 8429 patients
aged less than 60 years, high frequency of low-income and full health insurance
coverage (11% of the covered population) was found for CI (17.6%) and CH (24.6%).
Specific refund for invalidating stroke before hospitalization was found for 16%
of patients with CI and 10.5% of those with CH. During the two previous years,
around 7% of all patients were hospitalized for stroke, 30% for arterial
hypertension, 13% for cardiac electric disorders, 10% for coronary disease and
12% for diabetes. Death rates one month after hospitalization were 11.3% for CI
and 33.8% for CH, and two years after 22.5% for CI, 43% for CH and 7.7% for TIA.
At least one antihypertensive drug treatment was found for 55.2% of patients with
a TIA before hospitalization and 62.9% after and respectively 59.4% and 65.8% for
CI and 51.1% and 57.7% for CH. Before hospitalization, beta-blocker was the most
frequent antihypertensive class (21 to 25.6% according to stroke type). After
hospitalization, frequency increased for angiotensin-converting enzyme inhibitors
among CI patients (31% vs. 18.7%) and calcium-channel blockers among CH patients
(27.1% vs. 13.7%). Antiplatelet drugs were used by 58% of the patients with CI
after hospitalization (27.8% before). An anticoagulant drug was present for 74.8%
of patients with CI, 69.5% for TIA and 19.2% for CH. Among patients with ischemic
stroke, half of them had a lipid-lowering drug after hospitalization. A
combination of antihypertensive, anticoagulant and lipid lowering drugs was found
for 32.9% of patients with a TIA, 39.9% for CI and 7.6% for CH after
hospitalization. CONCLUSION: These patients presented frequently a history of
stroke and comorbidities and their level of secondary prevention must be
improved.
CI - Copyright (c) 2012 Elsevier Masson SAS. All rights reserved.

Langue : FRANCAIS