Safety of Monash Health Minor Stroke Pathway (MS-Home)

Ischemic stroke is due to a clot blocking a blood vessel impeding delivery of blood and nutrients. It can manifest as transient ischemic attack (TIA), minor stroke or a larger stroke. Earlier estimate suggests that the recurrence rate for TIA at 90 days was 10%. At Monash Health, we have established a pathway for managing TIA with high safety (low risk of recurrence~2.4%) and cost saving to the organisation. Minor stroke is defined as patients with mild stroke severity or National Institute of Health Stroke Scale (NIHSS) <=4. Approximately 30% to 40% of patients with stroke are classified as minor stroke. Advance in diagnostic evaluations and rehabilitation has meant that these patients can be safely managed in the outpatient setting. At Monash Health, the Minor Stroke pathway has been in existence for 5 years. The PhD candidate will be tasked with evaluating the safety of this pathway. The primary outcome will be recurrent stroke, hemorrhage and acute coronary syndrome. Skills to learn in this part will be data linkage to track the outcome in patients who have recurrent stroke but has attended other hospitals. Subsequent to this, the candidate will perform cost analysis of the outpatient pathway versus those who had been admitted. The candidate will be expected to perform statistical analysis in R.