OBJECTIVES:

To estimate the occurrence of spasticity and access to hospital rehabilitation in patients with a first event of stroke, using the Hospital Information System (HIS) of Italy.

METHODS:

From HIS, which collects information related to all discharges from public and private hospitals in Italy, we identified the cohort of patients aged ≥18 years discharged alive from a first acute hospitalization for, ischemic, haemorrhagic or subarachnoid stroke (index event) between January 2015 and December 2017.

Post-stroke spasticity patients were defined as all the patients with diagnoses or procedures imputable to spasticity either in the index event or in all the hospitalizations occurring within 12 months from the index event discharge date.

Patients who started post-stroke hospital rehabilitation were identified by selecting all patients with at least one rehabilitation hospitalization with principal diagnosis of “Late effects of cerebrovascular disease” within 12 months from the index event.

Analyses were performed for the whole study population and stratified by type of stroke: ischemic haemorrhagic, and subarachnoid.

RESULTS:

A cohort of 257,019 patients was selected (50.4% male, mean age 74.5 SD:13.3); 207,371 (80.7%) with ischemic stroke, 38,369 (14.9%) with haemorrhagic and 11,279 (4.4%) with subarachnoid stroke.

Overall, post-stroke spasticity occurred in 18.6% of patients: 18.5% for ischemic, 20.5% haemorrhagic and 13.4% for subarachnoid stroke.

45,924 (17.9%) patients started hospital rehabilitation within 12 months from stroke event, the proportion was equal to 17.2%, 22.6% and 14.9% for ischemic, haemorrhagic, and subarachnoid stroke respectively.

Considering patients with a diagnosis of post-stroke spasticity, only 37.6% accessed rehabilitation within the follow up period (12 months).

CONCLUSIONS:

The study, based on Italian administrative databases, allowed us to estimate the occurrence of spasticity in patients with a first event of stroke, highlighting a relevant proportion of patients do not access hospital rehabilitation (day hospital or inpatient) during follow-up.