Older Subjects Admitted to Hospital With Stroke From Long-Term Care: A National Cohort and Case Control Study.

Objectives: Internationally about 3% of people ≥65 years live in long-term care (LTC) settings. Older people living in nursing homes are more likely to be admitted to hospital. We examined the characteristics and outcomes of stroke patients admitted from LTC nationally and how this changed over the COVID-19 pandemic.

Should octogenarians and people aged 90 years and over be treated separately in studies of stroke? An evaluation of national audit data.

Introduction: Population studies frequently use ≥80 years for defining 'very old' but as mean life expectancy frequently exceeds 80 years internationally, this may no longer be appropriate. Those ≥90 years now represent a significant proportion of stroke patients. We examined national data to examine the differences between those 80-89 years and those 90+ years.

Effect of age on major trauma profile and characterisation: Analysis from the national major trauma audit in Ireland.

Background: Major trauma (MT) is a significant cause of morbidity and mortality worldwide, with older adult patients facing unique challenges due to age-related vulnerabilities and higher risks of falls. This study aimed to investigate differences in trauma characteristics, injury mechanisms, and outcomes of older adults compared to all younger patients with MT on a national level.

Methods: This retrospective cohort study analysed the national Major Trauma Audit data from 23,765 eligible patients with MT in Ireland of all ages and stratified into two age groups: those under 65 years (n = 12,620) and those aged 65 years or older (n = 11,145).

Anticoagulation usage and thrombolytic therapy in subjects with atrial fibrillation-associated ischemic stroke.

Background: Atrial fibrillation (AF) causes up to 20% of ischemic strokes and 30% in some populations such as those more than 80 years. Previous research showed that widespread adoption of Direct Oral Anticoagulant (DOAC) prophylaxis had not been associated with a reduction in AF-associated stroke prevalence but there was a considerable rate of breakthrough stroke in patients receiving anticoagulation and anticoagulation rate may be affected by increasing use of DOACs.

Aims: We undertook a more detailed study using the Irish National Audit of Stroke (INAS) to determine the characteristics of anticoagulation practice in AF-associated stroke, particularly breakthrough stroke, adherence to prescribing guidelines and effect on thrombolysis rate.

Hospital overcrowding and care of stroke patients: Irish national audit of stroke.

Introduction: Hospital overcrowding where patient admissions exceed capacity is associated with worse outcomes in Emergency Department. Developments in emergency stroke care have been associated with improvements in stroke outcome but are dependent on effective, organised care. We examined if overcrowding in the hospital system was associated with negative changes in stroke outcome.

The impact of hospital presentation time on stroke outcomes: A nationally representative Irish cohort study.

Objectives: There is conflicting evidence regarding the outcomes of acute stroke patients who present to hospital within normal working hours ('in-hours') compared with the 'out-of-hours' period. This study aimed to assess the effect of time of stroke presentation on outcomes within the Irish context, to inform national stroke service delivery.

Materials And Methods: A secondary analysis of data from the Irish National Audit of Stroke (INAS) from Jan 2016 to Dec 2019 was carried out.

Changes in anticoagulation practice in subjects admitted with stroke associated with atrial fibrillation, following introduction of direct oral anticoagulants over 2013-2021.

Background: The adoption of direct oral anticoagulants (DOACs) has changed practice in prevention of stroke in atrial fibrillation (AF). We used Irish data national data on stroke and anticoagulation therapy over 9 years to investigate changes in anticoagulation practice and potential consequences on stroke prevalence and thrombolysis.

Methods: AF, anticoagulation, thrombolysis, and stroke data from the Irish National Audit of Stroke (INAS) 2013-2021 were reviewed.