Specifics of outpatient follow-up and assessment of patients with the history of acute stroke depending of the profile of cardiovascular comorbidity according to the data of the outpatient registry REGION

Abstract

Aim. To study the specifics of follow-up, instrumental and laboratory assessment of patients with a history of acute cerebrovascular accident (ACVA), taking cardiovascular comorbidity into account. Material and methods. Within the outpatient phase of the REGION study, a register of patients with a history of ACVA of any remoteness (ACVA-AR registry, n=511), and the register of patients who had visited the outpatient clinic for the first time after cerebral stroke (ACVA-FV, n=475) were organized. The analysis of specifics of outpatient follow-up of patients during the last 12 months prior to the reference visit in the ACVA-AR registry and in the first 6 months after the reference visit in the ACVA-FV registry, depending on diagnosed concomitant cardiovascular diseases and their complications, conditions and the fact of being under dispensary observation was done. Results. During the analyzed period of follow-up in the outpatient clinic, the patients were most often examined by district therapeutists (ACVA-AR - 81.4%, ACVA-FV - 91.6%). Patients in the ACVA-AR registry had a statistically significantly higher incidence of electrocardiography, echocardiography and blood creatinine and total cholesterol results in patients with a history of myocardial infarction comparing to those who hadn’t myocardial infarction, as well as in a subset of patients who visited the clinic in comparison with those who were observed at home. Patients of the ACVA-FV registry were statistically significantly more often examined by doctors and had basic laboratory and instrumental examination methods done (except echocardiography) compared to those who were observed at home. The frequency of medical examinations, as well as the performance of instrumental and laboratory methods, was statistically significantly higher in the ACVA-FV register as a whole and in all analyzed groups comparing to the ACVA-AR registry, except for a subgroup of patients with a history of ACVA. Сonclusion. The quality of the examination of patients with a history of ACVA in the outpatient practice is inadequate; nevertheless, a comparison of the results of the ACVA-AR and ACVA-FV registers allows one to speak of its significant positive dynamics over the period of 2.3 years, which separated the reference visits in these registers.

Keywords

• acute cerebrovascular accident
• cerebral stroke
• transient ischemic attack
• outpatient practice
• register
• cardiovascular comorbidity
• follow-up