What question did this study set out to answer?

Determine whether substantial country-level variations in post-stroke outcomes in the International Stroke Trial can be explained by baseline patient characteristics or quality of care.

June 1, 2001StrokeOpen Access

Variations Between Countries in Outcome After Stroke in the International Stroke Trial (IST)

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Determine whether substantial country-level variations in post-stroke outcomes in the International Stroke Trial can be explained by baseline patient characteristics or quality of care.
Analyzed data from N=15,116 stroke patients across 9 countries (Argentina, Australia, Italy, the Netherlands, Norway, Poland, Sweden, Switzerland, and the United Kingdom) enrolled in the International Stroke Trial.
Evaluated crude case fatality and death or dependency at 6 months, using multivariable logistic regression to adjust for age, sex, atrial fibrillation, systolic blood pressure, consciousness, and neurological deficits.
Assessed quality of care using indicators such as prerandomization head CT scanning and discharge aspirin prescription.
Crude absolute differences between the highest- and lowest-performing countries were 171 per 1000 patients for mortality and 375 per 1000 patients for death or dependency.
Adjustment for baseline case mix reduced absolute disparities slightly to 160 per 1000 patients for mortality and 311 per 1000 patients for death or dependency.
Variations in process-of-care metrics accounted for only a portion of the residual outcome differences across participating nations.

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Implication

Multinational trial analysis reveals large country-level outcome variations after stroke, highlighting the necessity of stratified trial design.

Cite This Study

Weir et al. (2001) studied this question.

synapsesocial.com/papers/6a1d1426ba65f5ee325dbf72 https://doi.org/10.1161/01.str.32.6.1370

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Implication

Multinational trial analysis reveals large country-level outcome variations after stroke, highlighting the necessity of stratified trial design.

Variations Between Countries in Outcome After Stroke in the International Stroke Trial (IST)

Key Points

Discussion

Implication

Cite This Study

Variations Between Countries in Outcome After Stroke in the International Stroke Trial (IST)

Key Points

Discussion

Implication

Cite This Study

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