O-19 Effectiveness of an inpatient stroke unit in a resource limited setting: Findings from the Barbados National Registry

Methods: We used data from the Barbados National Registry for Non-communicable Diseases (BNR), for all diagnosed cases of acute stroke. We described the characteristics of those admitted to the Queen Elizabeth Hospital (reach). We examined clinical effectiveness using in-hospital case fatality rates. We assessed the adoption of stroke unit therapies by examining the factors associated with (occupational (OT), physiotherapy (PT) or speech therapy (ST)) using multivariable logistic regression models.

Results:Of the 2,491 strokes registered from 2016 to 2020, 38% were admitted to the stroke unit (SU). Admission rates ranged from 32% (2020) to 42% (p=0.012. Persons admitted to the SU tended to be younger (by 5 years), male, and had similar proportions of ischemic stroke, hypertension and diabetes compared to those on other wards. After adjusting for age, sex, Glasgow Coma Scale, co-morbidities, persons admitted to stroke unit were more likely to receive OT (Odds Ratio: 11.1 95% CI (8.0, 15.4)), PT (OR: 5.2 95% CI (3.3, 8.2)) and ST (OR: 6.6 95% CI (4.8, 9.1)) compared to those admitted to other wards. There was a non-statistically significant reduction in hospital case fatality for those admitted to SU versus those on other wards (OR: 0.77 95% CI (0.56, 1.06)).

Conclusion:We found SU admission led to more rehabilitative care and fewer deaths but less than half of eligible acute stroke patients were admitted. The admission reduction seen in 2020 was likely due to pandemic induced resource limitations.