Is Use of Mechanical Ventilation a Reasonable Proxy Indicator for Coma Among Medicare Patients Hospitalized for Acute Stroke?

Published in: Health Services Research, v. 32, no. 6, Feb. 1998, p. 841-859

Posted on RAND.org on December 31, 1997

by Ronnie D. Horner, Richard J. Sloane, Katherine L. Kahn

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The objective of this study was to ascertain whether use of mechanical ventilation on admission to hospital is a proxy indicator of coma (i.e., very severe stroke) among acute stroke patients. This was accomplished via a secondary analysis of data from a medical record review on a nationally representative sample of 2,824 Medicare patients, ages 65 years or older, who were hospitalized for stroke in 1982-1983 or 1985-1986 in 297 acute care hospitals in 30 areas within five geographically dispersed states. The study concluded that a stroke patient's use of mechanical ventilation on the first day of hospitalization is a valid proxy indicator of level of consciousness.

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