Trends in Acute Care and Rehabilitation for First-Ever Stroke Patients: A 12-Year Perspective, the KOSCO Study

Background: Updated data on stroke care trends are crucial for advancing stroke treatment. This study aimed to assess trends in inpatient care for first-ever stroke patients in South Korea over a 12-year period, focusing on demographic shifts and acute treatments including rehabilitation. Methods: This multicenter cohort study analyzed first-ever stroke patients admitted to three representative hospitals in South Korea during 2008 (n = 911), 2014 (n = 1,489), and 2020 (n = 1,434). The 2008 data were collected retrospectively, while 2014 and 2020 data were obtained from a prospective cohort study. Data included demographics, risk factors, stroke characteristics, hospital course, and rehabilitation treatments. Results: From 2008 to 2020, the mean age of stroke patients increased from 62.0 to 66.2 years. The proportion of ischemic stroke cases increased markedly from 47.3% to 74.5% while risk factors such as diabetes mellitus and hyperlipidemia showed increasing prevalence. Mechanical thrombectomy increased from 0% to 3.3%. Mean hospital stay decreased from 25.2 to 14.9 days, while in-hospital mortality declined from 5.9% to 3.7%. Rehabilitation consultations increased from 27.8% to 80.6%, occurring earlier during hospitalization. Rehabilitation therapy during hospitalization increased from 23.7% to 55.8%, and transfers to rehabilitation medicine rose from 12.8% to 19.1%. Home discharge increased from 34.8% to 60.0%. Conclusion: Management of first-ever stroke patients in Korea improved substantially over 12 years, reflecting positive impacts of national quality initiatives and advancing stroke care.