Background/Aims: Nearly 25% of people seek healthcare before a stroke, but differences by age or sex are unknown. We compared rates of healthcare encounters within 7 days before acute ischemic stroke (AIS) by age and sex.
Methods: We used linked data from Victoria, Australia (2012-2018) to identify first-ever AIS. Rates of health service encounters (emergency department [ED] presentations, hospital admissions, general practitioner [GP] and specialist visits) in the 7-days before AIS were compared across age (<65; 65-74; 75-84; and 85+ years) and sex (male/female) groups. We calculated crude and age-standardized rates (± 95% confidence intervals [CI]) using Poisson distribution, per 1,000 person-days.
Results: We included 30,731 AIS patients (77% aged ≥65 years; 53% male). In the 7 days before AIS, healthcare encounters per 1,000 person-days were: 12.0 hospital admissions (95% CI 10.9-13.2); 6.8 ED presentations (95% CI 5.8-7.9); 33.7 GP visits (95% CI 31.8- 35.7), and 9.1 specialist visits (95% CI 8.3-10.0). Hospital admissions did not differ by age or sex. Younger people (<65 years) had greater ED presentation rates (7.4 [95% CI 6.1-8.8]) than patients aged 75-84 years (4.6 [95% CI 4.1-5.2]), but lower specialist visits (7.1 vs.17.8 per 1000 person-days). Rates of GP visits were similar by age, but females had more GP visits than males (39.0 vs. 30.1 per 1000 person-days).
Conclusion: Younger patients have increased rates of ED presentations pre-stroke than older patients. Given the significant societal impacts of stroke in young patients, closer investigation is warranted to identify ED-based AIS risk-reduction interventions for this cohort.