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Table 3 Adherence to composite outcome and individual FeSS processes (2013–2017)

From: Inclusion of a care bundle for fever, hyperglycaemia and swallow management in a National Audit for acute stroke: evidence of upscale and spread

FeSS monitoring and treatment processes Univariable Multivariable
2013,N = 3741,n (%) 2015,N = 4087,n (%) 2017,N = 4192,n (%) 2013a–2015,OR (95% CI) 2013a–2017,OR (95% CI) 2015a–2017,OR (95% CI)
Individual FeSS processes       
 Fever treatment       
  Paracetamol within 1 hb, c 192 (36) 186 (39) 226 (49) 1.1 (0.85, 1.5) 1.7 (1.3, 2.2) 1.5 (1.1, 2.0)
  Overall fever treatmentb 3099 (90) 3800 (93) 3952 (94) 1.4 (1.2, 1.7) 1.7 (1.5, 2.1) 1.2 (1.0, 1.5)
 Hyperglycaemia treatment       
  Insulin within 1 hb 160 (25) 204 (29) 256 (38) 1.3 (0.97, 1.6) 2.0 (1.5, 2.5) 1.6 (1.2, 2.0)
  Overall hyperglycaemia treatmentb 2947 (86) 3579 (88) 3781 (90) 1.2 (1.0, 1.3) 1.5 (1.3, 1.8) 1.3 (1.1, 1.5)
 Swallow monitoring       
  Swallow screen OR assessment within 24 h of hospital admission 2310 (62) 2618 (64) 2884 (69) 1.2 (1.1, 1.3) 1.5 (1.3, 1.6) 1.3 (1.1, 1.4)
  Swallow screen or assessment before food or drink 1875 (50) 2222 (54) 2600 (62) 1.2 (1.1, 1.4) 1.7 (1.6, 1.9) 1.4 (1.3, 1.5)
  Swallow screen or assessment before oral medications 1687 (45) 2047 (50) 2420 (58) 1.3 (1.1, 1.4) 1.8 (1.6, 1.9) 1.4 (1.3, 1.5)
  Overall swallow monitoring 1401 (37) 1621 (40) 2059 (49) 1.2 (1.1, 1.3) 1.8 (1.6, 1.9) 1.5 (1.4, 1.7)
 Swallow treatment       
  Assessed by speech pathologist if failed swallow screen 562 (96) 769 (97) 826 (95) 1.3 (0.74, 2.3) 0.83 (0.50, 1.4) 0.64 (0.38, 1.1)
  Swallow treatmentd 3716 (99) 4061 (99) 4149 (99) 1.0 (0.58, 1.8) 0.62 (0.38, 1.1) 0.62 (0.38, 1.1)
 Swallow monitoring and treatment 1387 (37) 1599 (39) 2027 (48) 1.1 (1.0, 1.3) 1.7 (1.6, 1.9) 1.5 (1.4, 1.7)
Composite outcome       
 All elements of fever, sugar, swallow dysfunction monitored and treated 1024 (30)† 1290 (32) 1731 (41) 1.1 (1.0, 1.2) 1.8 (1.6, 2.0) 1.6 (1.4, 1.8)
  1. Dependent variable in multivariable analyses is adherence to FeSS processes; independent variable is year, adjusted for correlation within hospital. Italicised results are significant
  2. FeSS fever, sugar, swallow; OR odds ratio; CI confidence interval
  3. aYear used as reference for multivariable analyses
  4. bExcludes patients receiving palliative care in 2013
  5. cIn 2015/2017, those contraindicated to and already receiving regular paracetamol included as ‘no’ in denominator
  6. dAssessed by speech pathologist if failed swallow screen—those who passed or did not receive swallow screen were considered to have received appropriate treatment