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dc.contributor.authorSui, Y
dc.contributor.authorLuo, J
dc.contributor.authorDong, C
dc.contributor.authorZheng, L
dc.contributor.authorZhao, W
dc.contributor.authorZhang, Y
dc.contributor.authorXian, Y
dc.contributor.authorZheng, H
dc.contributor.authorYan, B
dc.contributor.authorParsons, M
dc.contributor.authorRen, L
dc.contributor.authorXiao, Y
dc.contributor.authorZhu, H
dc.contributor.authorRen, L
dc.contributor.authorFang, Q
dc.contributor.authorYang, Y
dc.contributor.authorLiu, W
dc.contributor.authorXu, B
dc.date.accessioned2020-11-26T23:21:05Z
dc.date.available2020-11-26T23:21:05Z
dc.date.issued2021-03-01
dc.identifierpii: svn-2020-000332
dc.identifier.citationSui, 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., Yang, Y., Liu, W. & 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), pp.87-94. https://doi.org/10.1136/svn-2020-000332.
dc.identifier.issn2059-8688
dc.identifier.urihttp://hdl.handle.net/11343/252196
dc.description.abstractBACKGROUND: 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.
dc.languageEnglish
dc.publisherBMJ PUBLISHING GROUP
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0
dc.titleImplementation of regional Acute Stroke Care Map increases thrombolysis rates for acute ischaemic stroke in Chinese urban area in only 3 months
dc.typeJournal Article
dc.identifier.doi10.1136/svn-2020-000332
melbourne.affiliation.departmentMedicine (RMH)
melbourne.affiliation.facultyMedicine, Dentistry & Health Sciences
melbourne.source.titleStroke and Vascular Neurology
melbourne.source.volume6
melbourne.source.issue1
melbourne.source.pages87-94
dc.rights.licenseCC BY-NC
melbourne.elementsid1466413
melbourne.contributor.authorYan, Bernard
melbourne.contributor.authorParsons, Mark
dc.identifier.eissn2059-8696
melbourne.accessrightsOpen Access


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