Abstract:
Objective To evaluate the improvement of medical service capacity for patients with acute ischemic stroke before and after the implementation of “Stroke recognition in thousands of Counties and towns in China” in Nantong.
Methods This study was a multi-center , prospective, interventional, self-controlled study, aim to analyze and compare the admission rate, intravenous thrombolysis rate, intravascular therapy rate, door to needle time (DNT), door to puncture time (DPT) of patients with acute ischemic stroke from 15 hospitals in Nantong bwtween 2020 (January to December 2020) and 2021 (January to December 2021), that is, before and after the implementation of ‘Stroke recognition in thousands of counties and towns’. χ2 tests were used to compare the difference of event rate and Wilcoxon signed-rank tests were used to compare time variables (DNT and DPT).
Results In 2021, the hospital admission rate of patients with acute ischemic stroke within 4.5 h, 6 h and 24 h of onset increased significantly compared with that in 2020 (22.4% vs 16.8%, 34.9% vs 27.0%, 56.5% vs 47.2%, χ2=109.588, 163.195, 186.415; all P＜0.001). The rate of intravenous thrombolysis within 4.5 h and 14 d of onset in 2021 was significantly higher than that in 2020 (53.1% vs 46.0%, 11.9% vs 7.7%; χ2=20.918, 107.849; both P＜0.001). The rate of endovascular therapy within 6 h, 24 h and 14 d of onset in 2021 were significantly higher than that in 2020 (6.8% vs 3.5%, 4.7% vs 2.0%, 2.6% vs 0.9%; χ2=34.615, 62.053, 91.924; all P＜0.001). The median DNT of intravenous thrombolysis in 2021 was reduced compared with that in 2020 (53.8 min vs 70.9 min, Z=0.733, P＜0.001). The median DPT of endovascular therapy in 2021 was lower than that in 2020 (119.6 min vs 142.5 min) with no statistical significance (P＞0.05)
Conclusion The “Stroke recognition in thousands of counties and town in China’ carried out in Nantong increased the hospital attendance rate, intravenous thrombolysis rate and intravascular treatment rate, shortened intravenous thrombolysis time, and improved the medical service capacity of acute ischemic stroke.
Key words:
Acute ischemic stroke,
Stroke recognition in thousands of counties and towns in China,
Medical service capacity
Qiuhong Ji, Kaifu Ke, Juntao Shen, Fei Xu, Hong Zhang, Tian Xu, Kewei Liu, Jianlin Gao, Baohua Chao. Study on improvement of medical service capacity of acute ischemic stroke before and after stroke recognition in thousands of counties and towns in China[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2022, 16(02): 84-87.