Caroline Baker (Australia)
Centre of Research Excellence in Aphasia Recovery and Rehabilitation N/AAuthor Of 1 Presentation
FACTORS ASSOCIATED WITH APHASIA FOLLOWING STROKE USING LINKED CLINICAL REGISTRY AND HOSPITAL DATA
Abstract
Background and Aims
The reasons people with post-stroke aphasia have poor health outcomes are not well understood. We aimed to determine factors associated with aphasia, and compare the frequency of post-stroke hospital readmissions amongst patients with and without aphasia.
Methods
Patient-level data from the Australian Stroke Clinical Registry (years 2009-2013) were linked to national death data, hospital emergency presentations and admissions data from Victoria, Queensland, New South Wales and Western Australia. Multivariable logistic regression was used to assess factors associated with aphasia identified from ICD10 discharge codes for the index stroke event. Cox regression was used for hospital readmissions within 30 days, 90 days, 180 days and 1-year. Comorbidities were identified using ICD-10 coded admission data from 5-years prior to the stroke event.
Results
12,690 adults with stroke were included (median age 76; 54% male; 77% ischaemic stroke); 26% identified with aphasia. The factors most strongly associated with aphasia were prior diagnosis of stroke (aOR 7.76, 95%CI 2.44-24.7; p<0.001), paraplegia (aOR 1.57, 95%CI 1.42-1.75; p<0.001), and atrial fibrillation (aOR 1.56, 95%CI 1.41-1.73; p<0.001). Compared to people without aphasia, people with aphasia more often had a hospital readmission within 180 days (HR 1.11, 95%CI 1.02-1.22; p=0.009), and 1-year (HR 1.12, 95%CI 1.03-1.21; p=0.005). Hospital readmissions within 30 days and 90 days were not significantly different.
Conclusions
Patients with prior stroke are more likely to experience aphasia following a new stroke event. Early aphasia-specific secondary stroke prevention, education and support may help reduce the prevalence of post-stroke aphasia and hospital readmissions.