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Published, Version of Record (VoR)Open Access (License Unspecified), Open
Journal article
Recurrent stroke in midlife is associated with not having a primary care physician
Neurology, v 92(6), pp e560-e566
05 Feb 2019
PMID: 30610095
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To determine using a population-based study whether midlife stroke patients having a primary care physician (PCP) at the time of first stroke have a lower risk of stroke recurrence and mortality than those who do not have a PCP.
First-ever ischemic stroke patients 45 to 64 years of age at stroke onset were ascertained through the Brain Attack Surveillance in Corpus Christi (BASIC) project from 2000 to 2013 in Texas. Cox proportional hazards models were used to examine the association between not having a PCP and stroke recurrence or all-cause mortality in separate models. Cases were followed up for up to 5 years or until December 31, 2013, whichever came first. Cases were censored for recurrence if they died before experiencing a recurrent event. We adjusted for clinical risk factors that could be associated with having a PCP and recurrence or mortality.
There were 663 first-occurrence ischemic stroke cases. Of these, 77% had a PCP, 43% were female, and average age was 55.6 years. Five-year recurrence risk was 14.6%, and mortality risk was 19.2%. Not having a PCP was associated with higher recurrence risk (adjusted hazard ratio 1.75, 95% confidence interval 1.02-3.02). Having a PCP was not associated with mortality. Sensitivity analyses showed that results were robust to different ways to adjust for chronic conditions.
This study found lower rates of stroke recurrence among those with a PCP at the time of first stroke. Future studies could determine the value of establishing a PCP before stroke hospital discharge for secondary stroke prevention.
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Details
- Title
- Recurrent stroke in midlife is associated with not having a primary care physician
- Creators
- Rebecca J Lank - University of MichiganLynda D Lisabeth - University of MichiganBrisa N Sánchez - University of MichiganDarin B Zahuranec - University of MichiganKevin A Kerber - University of MichiganLesli E Skolarus - University of MichiganJames F Burke - University of MichiganDeborah A Levine - University of MichiganErin Case - University of MichiganDevin L Brown - University of MichiganLewis B Morgenstern - University of Michigan
- Publication Details
- Neurology, v 92(6), pp e560-e566
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000462355900014
- Scopus ID
- 2-s2.0-85061124874
- Other Identifier
- 991020099923704721
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Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Clinical Neurology