Regional variation in acute stroke care organisation

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dc.contributor.authorMuñoz Venturelli, Paula
dc.contributor.authorRobinson, Thompson
dc.contributor.authorLavados, Pablo
dc.contributor.authorOlavarría, Verónica V
dc.contributor.authorArima, Hisatomi
dc.contributor.authorBillot, Laurent
dc.contributor.authorHackett, Maree L
dc.contributor.authorLim, Joyce Y
dc.contributor.authorMiddleton, Sandy
dc.contributor.authorPontes-Neto, Octavio
dc.contributor.authorPeng, Bin
dc.contributor.authorCui, Liying
dc.contributor.authorSong, Lily
dc.contributor.authorMead, Gillian
dc.contributor.authorWatkins, Caroline
dc.contributor.authorLin, Ruey-Tay
dc.contributor.authorLee, Tsong-Hai
dc.contributor.authorPandian, Jeyaraj
dc.contributor.authorAsita de Silva, H
dc.contributor.authorAnderson, Craig S
dc.date.accessioned2022-01-04T21:43:52Z
dc.date.available2022-01-04T21:43:52Z
dc.date.issued2016
dc.description.abstractBackground: Few studies have assessed regional variation in the organisation of stroke services, particularly health care resourcing, presence of protocols and discharge planning. Our aim was to compare stroke care organisation within middle- (MIC) and high-income country (HIC) hospitals participating in the Head Position in Stroke Trial (HeadPoST). Methods: HeadPoST is an on-going international multicenter crossover cluster-randomized trial of 'sitting-up' versus 'lying-flat' head positioning in acute stroke. As part of the start-up phase, one stroke care organisation questionnaire was completed at each hospital. The World Bank gross national income per capita criteria were used for classification. Results: 94 hospitals from 9 countries completed the questionnaire, 51 corresponding to MIC and 43 to HIC. Most participating hospitals had a dedicated stroke care unit/ward, with access to diagnostic services and expert stroke physicians, and offering intravenous thrombolysis. There was no difference for the presence of a dedicated multidisciplinary stroke team, although greater access to a broad spectrum of rehabilitation therapists in HIC compared to MIC hospitals was observed. Significantly more patients arrived within a 4-h window of symptoms onset in HIC hospitals (41 vs. 13%; P<0.001), and a significantly higher proportion of acute ischemic stroke patients received intravenous thrombolysis (10 vs. 5%; P=0.002) compared to MIC hospitals. Conclusions: Although all hospitals provided advanced care for people with stroke, differences were found in stroke care organisation and treatment. Future multilevel analyses aims to determine the influence of specific organisational factors on patient outcomes.es
dc.identifier.citationMuñoz Venturelli P, Robinson T, Lavados PM, Olavarría VV, Arima H, Billot L, Hackett ML, Lim JY, Middleton S, Pontes-Neto O, Peng B, Cui L, Song L, Mead G, Watkins C, Lin RT, Lee TH, Pandian J, de Silva HA, Anderson CS; HeadPoST Investigators. Regional variation in acute stroke care organisation. J Neurol Sci. 2016 Dec 15;371:126-130.es
dc.identifier.urihttp://dx.doi.org/10.1016/j.jns.2016.10.026es
dc.identifier.urihttp://hdl.handle.net/11447/5343
dc.language.isoen_USes
dc.subjectAcute ischemic strokees
dc.subjectIn- and out-hospital stroke care organisationes
dc.subjectIntracerebral hemorrhagees
dc.subjectStrokees
dc.subjectStroke carees
dc.subjectThrombolysis.es
dc.titleRegional variation in acute stroke care organisationes
dc.typeArticlees

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