Temporal Changes in the Quality of Acute Stroke Care in Five National Audits across Europe
Table 3
Variations and changes in quality of care over time, 2004–2009, center participating continuously over the whole study period.
2004
2005
2006
2007
2008
2009
VPC‡‡
%
OR (95% CI)
%
OR (95% CI)
%
OR (95% CI)
%
OR (95% CI)
%
OR (95% CI)
%
OR (95% CI)
Swallowing test done†
ADSR
#
#
#
#
#
#
52.9
1.00
63.7
1.65 (1.60–1.70)
70.3
2.44 (2.37–2.52)
0.3847
POLKARD
#
#
#
#
#
#
#
#
#
#
#
#
#
SSCA
#
#
74.9
1.00
78.4
1.10 (0.99–1.21)
73.3
1.02 (0.93–1.12)
72.4
0.88 (0.80–0.96)
83.8
1.94 (1.75–2.15)
0.2697
Riks-Stroke
#
#
#
#
#
#
84.1
1.00
89.1
1.65 (1.55–1.76)
92.7
2.68 (2.50–2.86)
0.0851
NSSA
75.4
1.00
#
#
77.2
1.08 (1.01–1.16)
#
#
81.2
1.45 (1.34–1.56)
#
#
0.1263
Thrombolysis‡
ADSR
6.0
1.0
7.1
1.20 (1.11–1.30)
#
#
8.6
1.57 (1.45–1.69)
9.5
1.70 (1.58–1.82)
11.2
2.04 (1.90–2.19)
0.2794
POLKARD
0.9
1.0
0.6
0.70 (0.43–1.14)
#
#
1.5
1.85 (1.33–2.57)††
1.2
1.83 (1.05–3.17)††
#
#
0.3866
SSCA
#
#
#
#
#
#
#
#
#
#
#
#
#
Riks-Stroke
2.2
1.0
3.4
1.54 (1.31–1.82)
3.6
1.66 (1.41–1.96)
5.6
2.60 (2.24–3.03)
7.0
3.27 (2.82–3.79)
7.9
3.74 (3.24–4.32)
0.0824
NSSA
#
#
#
#
#
#
#
#
#
#
#
#
#
Treatment Stroke Unit
ADSR
#
#
#
#
#
#
#
#
#
#
#
#
#
POLKARD
86.7
1.0
91.3
1.99 (1.75–2.27)
#
#
90.0
1.71 (1.54–1.89)††
91.2
1.90 (1.59–2.27)††
#
#
0.5592
SSCA
#
#
66.2
1.0
72.7
1.25 (1.15–1.36)
76.0
1.49 (1.36–1.62)
74.6
1.36 (1.25–1.48)
78.1
1.71 (1.57–1.87)
0.3382
Riks-Stroke
77.4
1.0
78.0
1.07 (1.02–1.12)
81.1
1.30 (1.24–1.37)
82.1
1.38 (1.31–1.45)
84.0
1.58 (1.50–1.66)
86.8
2.04 (1.94–2.15)
0.2299
NSSA
45.6
1.0
#
#
61.4
2.46 (2.30–2.64)
#
#
72.8
4.07 (3.78–4.37)
#
#
0.3745
Antiplatelet therapy||
ADSR
91.4
1.0
91.4
0.98 (0.92–1.05)
#
#
95.5
1.92 (1.77–2.08)
96.4
2.35 (2.17–2.55)
97.0
2.73 (2.52–2.96)
0.0964
POLKARD
93.4
1.0
93.7
1.10 (0.93–1.30)
#
#
94.1
1.18 (1.03–1.36)††
88.8
0.68 (0.56–0.82)††
#
#
0.1520
SSCA
#
#
85.3
1.0
87.8
1.24 (1.08–1.42)
88.8
1.38 (1.21–1.58)
90.7
1.72 (1.49–1.98)
88.1
1.30 (1.14–1.48)
0.0239
Riks-Stroke
91.7
1.0
91.3
0.95 (0.87–1.03)
91.4
0.96 (0.88–1.04)
92.1
1.06 (0.97–1.15)
91.6
0.99 (0.91–1.08)
91.5
0.97 (0.90–1.06)
0.0239
NSSA
97.7
1.0
#
#
96.4
0.67 (0.51– 0.86)
#
#
97.6
1.04 (0.80– 1.36)
#
#
0.21790
Anticoagulant therapy
ADSR
37.7
1.0
36.6
0.99 (0.92–1.07)
#
#
49.6
1.82 (1.69–1.96)
52.2
2.06 (1.91–2.21)
55.3
2.30 (2.15–2.47)
0.1014
POLKARD
26.0
1.0
26.4
0.99 (0.82–1.21)
#
#
25.0
0.94 (0.80–1.11)††
20.5
0.76 (0.58–1.01)††
#
#
0.1436
SSCA
#
#
39.5
1.0
38.6
0.89 (0.69–1.15)
41.0
1.10 (0.83–1.44)
37.8
0.93 (0.70–1.24)
30.7
0.88 (0.66–1.18)
0.1297
Riks-Stroke
32.5
1.0
31.6
0.96 (0.87–1.05)
31.0
0.95 (0.87–1.05)
33.0
1.09 (0.99–1.20)
36.1
1.24 (1.13–1.36)
37.2
1.37 (1.25–1.51)
0.0556
NSSA
37.6
1.0
#
#
32.9
0.86 (0.70–1.05)
#
#
34.3
0.94 (0.77–1.15)
#
#
0.0456
Analyses were restricted to patients without missing values; % refers to patients adhering to the specific quality indicator; OR: odds ratio; CI: confidence interval; OR and 95% CI were derived from a logistic regression model adjusted for age, sex, stroke subtype (if applicable), day of admission, AF, and level of consciousness; #not documented or not documented in a comparable way or no documentation in the respective year; †all patients with IS, ICH, or UND and patients with swallowing test done and unassessable status; ‡In IS only, age between 18 and 80 years; all patients with IS, ICH, or UND; ||anytime during stay or at discharge in patients with IS alive at discharge and without anticoagulant therapy; anytime during stay or at discharge or recommended at discharge in patients with IS and AF alive at discharge; ††POLKARD no complete calendar year of documentation; ‡‡variance partition coefficient, to account for between-centers variation within the audits.
