- Title
- Management of stroke in the Australian indigenous population: from hospitals to communities
- Creator
- Tiedeman, Clare; Suthers, Belinda; Julien, Benjamin; Hackett, Anna; Oakley, Patrick
- Relation
- Internal Medicine Journal Vol. 49, Issue 8, p. 962-968
- Publisher Link
- http://dx.doi.org/10.1111/imj.14303
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2019
- Description
- Background: Ischaemic strokes lead to significant morbidity and mortality within the Australian Indigenous population, with known variances in the management of strokes between indigenous and non-indigenous populations. Aims: To compare investigations and management of indigenous and non-indigenous patients presenting to a New South Wales rural referral hospital with an ischaemic stroke to the national stroke standards across inpatient and outpatient settings. Methods: Historical cohort study of 43 indigenous and 167 non-indigenous patients admitted to Tamworth Rural Referral Hospital with an ischaemic cerebrovascular accident. Results: Indigenous patients were significantly less likely to have investigations completed, including carotid imaging (93.8% vs 100%, P = 0.012) and echocardiography (73.3% vs 97.7%, P = 0.004). Discharge follow up was significantly lower for the indigenous population (74.4% vs 87.4%, P = 0.034). Indigenous stroke patients were 15.8 years younger than non-indigenous subjects (56.8 vs 72.6 years old; P < 0.001). Indigenous patients were more likely to have stroke risk factors, including smoking (51.2% vs 15.0%; P < 0.001), diabetes mellitus (37.2% vs 16.8%, P = 0.003) and past history of cerebrovascular accident or transient ischaemic attack (50.2% vs 31.1%, P = 0.032). Conclusions: The investigation and post-discharge care of indigenous ischaemic stroke patients is inferior to non-indigenous patients. Indigenous patients within rural NSW have a higher prevalence of preventable disease, including those that confer a higher stroke risk. Further research is needed to investigate the cause of these discrepancies and to improving indigenous stroke care between hospitals and primary care providers.
- Subject
- stroke; aboriginal health; indigenous; Aboriginal and torres Islander; oceanic ancestry group; cerebrovascular accident; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1443856
- Identifier
- uon:42121
- Identifier
- ISSN:1444-0903
- Language
- eng
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