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Implementation of regional Acute Stroke Care Map increases thrombolysis rates for acute ischaemic stroke in Chinese urban area in only 3 months.

Publication ,  Journal Article
Sui, Y; Luo, J; Dong, C; Zheng, L; Zhao, W; Zhang, Y; Xian, Y; Zheng, H; Yan, B; Parsons, M; Ren, L; Xiao, Y; Zhu, H; Ren, L; Fang, Q ...
Published in: Stroke and vascular neurology
March 2021

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.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.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.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.

Duke Scholars

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Published In

Stroke and vascular neurology

DOI

EISSN

2059-8696

ISSN

2059-8688

Publication Date

March 2021

Volume

6

Issue

1

Start / End Page

87 / 94

Related Subject Headings

  • Treatment Outcome
  • Tissue Plasminogen Activator
  • Thrombolytic Therapy
  • Ischemic Stroke
  • Humans
  • Critical Pathways
 

Citation

APA
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MLA
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Sui, Y., Luo, J., Dong, C., Zheng, L., Zhao, W., Zhang, Y., … Xu, B. (2021). 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, 6(1), 87–94. https://doi.org/10.1136/svn-2020-000332
Sui, Yi, Jianfeng Luo, Chunyao Dong, Liqiang Zheng, Weijin Zhao, Yao Zhang, Ying Xian, et al. “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 6, no. 1 (March 2021): 87–94. https://doi.org/10.1136/svn-2020-000332.
Sui Y, Luo J, Dong C, Zheng L, Zhao W, Zhang Y, et al. 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. 2021 Mar;6(1):87–94.
Sui, Yi, et al. “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, vol. 6, no. 1, Mar. 2021, pp. 87–94. Epmc, doi:10.1136/svn-2020-000332.
Sui Y, Luo J, Dong C, Zheng L, Zhao W, Zhang Y, Xian Y, Zheng H, Yan B, Parsons M, Ren L, Xiao Y, Zhu H, Fang Q, Yang Y, Liu W, Xu B. 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. 2021 Mar;6(1):87–94.

Published In

Stroke and vascular neurology

DOI

EISSN

2059-8696

ISSN

2059-8688

Publication Date

March 2021

Volume

6

Issue

1

Start / End Page

87 / 94

Related Subject Headings

  • Treatment Outcome
  • Tissue Plasminogen Activator
  • Thrombolytic Therapy
  • Ischemic Stroke
  • Humans
  • Critical Pathways