Original articleIncidence and Profile of Inpatient Stroke-Induced Aphasia in Ontario, Canada
Section snippets
Study Population and Data Collection
The RCSN was established in 2001 to enable the measurement and monitoring of stroke care delivery and outcomes for Canadian patients at participating institutions. Currently, RCSN data include records from more than 30,000 adult stroke patients seen at 12 hospitals designated as regional stroke centers in the province of Ontario. Data are collected from prehospital stroke onset to discharge from acute care after a stroke. Facilities that are designated as regional stroke centers are required to
Incidence of Aphasia
A total of 3207 patients with a primary diagnosis of stroke were included in the 2004 to 2005 Ontario Stroke Audit. Of these, 965 (30%) had aphasia on admission, while 1131 (35%) had aphasia at the time of discharge (after an average length of stay of 15d). Using the number of patients with aphasia present at discharge and weighting the Ontario Stroke Audit data to reflect the general adult population in Ontario27 resulted in an overall incidence rate of .06%, or 60 per 100,000 persons per year
Discussion
This large Canadian study indicated that approximately 35% of stroke patients have aphasia at the time of discharge. This finding supports current literature that reports approximately one quarter to one third of patients with stroke experience aphasia.1, 11, 13, 14 Adjusted to the European standard population, the incidence rate reported for ages 20 years and older (48 per 100,000) is more than double the standardized incidence rate of 21 per 100,000 persons reported in the most recent
Conclusions
In summary, we found that the profile and patterns of service use for stroke patients with aphasia differed significantly from those who did not experience aphasia as a residual disability after stroke, particularly in relation to service usage. Given the numbers of patients who acquire aphasia, the complexity of this communication disorder, and its impact on those who acquire it, there is a need to develop more rigorous standards regarding the assessment and collection of data related to
Acknowledgments
We thank J. Charles Victor, MSc, for his epidemiologic expertise and advice throughout the preparation of this article; Jeffrey Hoch, PhD, and Michelle Christian for their ideas concerning the focus and format of this article; and Ada Mok for administrative assistance. We also acknowledge the participation of the regional stroke centers in Ontario (see appendix 1 for full list of participating facilities).
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The Institute for Clinical Evaluative Sciences (ICES), which provided the data for this study, is supported by an operating grant from the Ontario Ministry of Health and Long-Term Care. The Registry of the Canadian Stroke Network (RCSN) was funded by a grant from the Canadian Stroke Network. The views expressed here do not necessarily reflect those of the Ministry.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.