London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 631 541 Epidemiology of stroke Trends in in-hospital mortality, complications and treatments of stroke over the past 11 years J. Minnerup1, H. Wersching2, M. Unrath3, K. Berger4 University of Münster, Münster, GERMANY1, University of Münster, Münster, GERMANY2, University of Münster, Münster, GERMANY3, University of Münster, Münster, GERMANY4 Background: Stroke mortality decreased within the last years. However, the reasons for the reduc-tion of stroke mortality are unknown so for. The aim of the present study was therefore to describe in-hospital mortality over an 11-year period and to evaluate whether changes in mortality were relat-ed to changes in patients characteristics, complication frequency, or treatments. Methods: This study was based on a prospective database of the Stroke Register of Northwestern Germany, which included 289,768 ischemic stroke patients admitted between January 2000 and De-cember 2011. Trends in the overall in-hospital mortality as well as mortality in subgroups according to age, sex, stroke severity on admission, risk factors, stroke etiology, and comorbidities were ana-lyzed. Moreover, changes in complications and treatments were investigated. Results: Overall, the in-hospital mortality decreased from 6.8% in 2000 to 5.6% in 2011 (P < 0.05 for trend). The mortality declined independently of age, sex, stroke etiology, and comorbidities. This trend of a decreased mortality was pronounced in patients with mild and moderate stroke se-verity. The frequency of complications, such as infections and recurrent stroke decreased (P <0.05 for trend). The proportion of patients treated with thrombolysis, antiplatelet therapy within 48 hours of symptom onset, antihypertensive medication, and statins significantly increased over time (P < 0.05). Conclusion: In the Stroke Register of Northwestern Germany in-hospital stroke mortality rates de-clined between 2000 and 2011. During this time, there was a decrease in complications following the stroke and an increase in evidence-based treatments. 542 Epidemiology of stroke The Associations of subjective Sleep Disorders with Stroke diagnosis in Community Dwelling Elders. The Irish Longitudinal Study of Ageing. J.A. Harbison1, R.A. Kenny2, H. Cronin3, P. Kearney4, C. Finucane5 The Irish Longitudinal Study of Ageing, Trinity College Dublin, Dublin, IRELAND1, The Irish Longitudinal Study of Ageing, Trinity College Dublin, Dublin, IRELAND2, The Irish Longitudinal Study of Ageing, Trinity College Dublin, Dublin, IRELAND3, The Irish Longitudinal Study of Age-ing, Trinity College Dublin, Dublin, IRELAND4, The Irish Longitudinal Study of Ageing, Trinity College Dublin, Dublin, IRELAND5 Introduction: Subjective sleep disorders such as insomnia and daytime sleepiness, are commonly reported following stroke. We analysed data from TILDA to determine the prevalence of sleep disor-ders in a large, community sample of people >50 years and their association with a history of stroke. Methods: 3 questions assessing sleep quality were included. Daytime sleepiness: ‘How likely are you to doze off or fall asleep during the day?’ (Never, Slight, Moderate or High Risk?). Insomnia at sleep initiation: ‘How often do you have trouble falling asleep?’ and sleep maintenance insomnia: ‘How often do you have trouble with waking up too early and not being able to fall asleep?’ (Most of the time, Sometimes or Rarely or Never). Results: Responses were obtained from 8504 subjects (4724 female). Significant daytime sleepiness (‘Moderate’ ‘High risk’) was commoner in men (35.4% vs 24.7%**). On multvariate analysis, as-sociations were not found with Stroke (Odds Ratio 0.96, p=0.87) but were found with age (1.03**), frailty (Pre-Frail: O.R. 1.42, p<0.0001, Frail 2.242**), polypharmacy (1.25**) and heart failure (1.77, p=0.043). Female gender was associated with reduced risk (0.58**). Significant insomnia at sleep onset (‘Most of the time’) was commoner in women than men (13.4% vs 7.4%**). It was not associated with Stroke (OR 0.90, p=0.65) but was associated with increas-ing frailty (pre-frail: 1.43**, frail 2.18**), female gender (2.42**), education (2nd level: OR, 0.84, p=0.02, 3rd level: 070**) and polypharmacy (1.62**). Significant insomnia for sleep maintenance (‘Most of the time’) was also commoner in women (17.8% vs.13.4%**) and was associated with, frailty (Pre-Frail: Odds Ratio 1.42**, Frail 2.24**)), female gender (1.41**), polypharmacy (1.28, p=0.001) and 3rd level education (0.87**). Stroke was associated with reduced risk of insomnia (0.64, p=0.046). Conclusion. In this study, Stroke was not associated with worse subjective sleep quality. ** P<0.001
Karger_ESC London_2013
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