Implementation of regional Acute Stroke Care Map increases thrombolysis rates for acute ischaemic stroke in Chinese urban area in only 3 months.
Repository Usage Stats
BACKGROUND:The rate of intravenous thrombolysis for acute ischaemic stroke remains low in China. We investigated whether the implementation of a citywide Acute Stroke Care Map (ASCaM) is associated with an improvement of acute stroke care quality in a Chinese urban area. METHODS:The ASCaM comprises 10 improvement strategies and has been implemented through a network consisting of 20 tertiary hospitals. We identified 7827 patients with ischaemic stroke admitted from April to October 2017, and 506 patients underwent thrombolysis were finally included for analysis. RESULTS:Compared with 'pre-ASCaM period', we observed an increased rate of administration of tissue plasminogen activator within 4.5 hours (65.4% vs 54.5%; adjusted OR, 1.724; 95% CI 1.21 to 2.45; p=0.003) during 'ASCaM period'. In multivariate analysis models, 'ASCaM period' was associated with a significant reduction in onset-to-door time (114.1±55.7 vs 135.7±58.4 min, p=0.0002) and onset-to-needle time (ONT) (169.2±58.1 vs 195.6±59.3 min, p<0.0001). Yet no change was found in door-to-needle time. Clinical outcomes such as symptomatic intracranial haemorrhage, favourable functional outcome (modified Rankin Scale ≤2) and in-hospital mortality remained unchanged. CONCLUSION:The implementation of ASCaM was significantly associated with increased rates of intravenous thrombolysis and shorter ONT. The ASCaM may, in proof-of-principle, serve as a model to reduce treatment delay and increase thrombolysis rates in Chinese urban areas and possibly other highly populated Asian regions.
Published Version (Please cite this version)10.1136/svn-2020-000332
Publication InfoSui, Yi; Luo, Jianfeng; Dong, Chunyao; Zheng, Liqiang; Zhao, Weijin; Zhang, Yao; ... Xu, Bing (2020). Implementation of regional Acute Stroke Care Map increases thrombolysis rates for acute ischaemic stroke in Chinese urban area in only 3 months. Stroke and vascular neurology. 10.1136/svn-2020-000332. Retrieved from https://hdl.handle.net/10161/21567.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
More InfoShow full item record
Associate Professor in Neurology
Dr. Xian is an Associate Professor of Neurology and Medicine at the Duke University Medical Center and Duke Clinical Research Institute. He received his Medical Degree from Beijing Medical University (Peking University Health Science Center) and completed an Internal Medicine Residency and Cardiology Fellowship at Peking University People’s Hospital, and Fuwai Hospital, Peking Union Medical College. Dr. Xian’s research is dedicated to improving health care quality and outcomes in