BACKGROUND AND PURPOSE: Guidelines and performance indicators have been established for acute stroke care. However, little is known about the process of stroke care delivery in Canada. METHODS: The Registry of the Canadian Stroke Network (RCSN) captured detailed clinical data on patients with stroke and transient ischemic attack seen at 21 acute care institutions across Canada. Data from phase 1 of the RCSN (June 2001 to February 2002) were used to determine the use of evidence-based acute stroke care interventions in participating institutions. RESULTS: Overall, 4439 patients were seen during the study time frame and 1701 (38%) consented to full data collection. Thirty-one percent received care on a stroke unit or from a mobile stroke team. Among patients with ischemic stroke, 7% received thrombolysis, 80% underwent carotid imaging, 89% received antithrombotic agents, and 54% of those with atrial fibrillation received warfarin. There were significant intersite variations in the delivery of all of these interventions except for the use of antithrombotic agents, and these persisted after adjustment for age, sex, stroke type, and other comorbid conditions. CONCLUSIONS: Patients in institutions participating in the RCSN received high-quality stroke care based on a number of performance measures. However, gaps exist in the provision of other elements of stroke care, particularly organized inpatient stroke care and warfarin for atrial fibrillation. Future research should explore explanations for these findings and focus on solutions to deficiencies in care.
BACKGROUND AND PURPOSE: Guidelines and performance indicators have been established for acute stroke care. However, little is known about the process of stroke care delivery in Canada. METHODS: The Registry of the Canadian Stroke Network (RCSN) captured detailed clinical data on patients with stroke and transient ischemic attack seen at 21 acute care institutions across Canada. Data from phase 1 of the RCSN (June 2001 to February 2002) were used to determine the use of evidence-based acute stroke care interventions in participating institutions. RESULTS: Overall, 4439 patients were seen during the study time frame and 1701 (38%) consented to full data collection. Thirty-one percent received care on a stroke unit or from a mobile stroke team. Among patients with ischemic stroke, 7% received thrombolysis, 80% underwent carotid imaging, 89% received antithrombotic agents, and 54% of those with atrial fibrillation received warfarin. There were significant intersite variations in the delivery of all of these interventions except for the use of antithrombotic agents, and these persisted after adjustment for age, sex, stroke type, and other comorbid conditions. CONCLUSIONS:Patients in institutions participating in the RCSN received high-quality stroke care based on a number of performance measures. However, gaps exist in the provision of other elements of stroke care, particularly organized inpatient stroke care and warfarin for atrial fibrillation. Future research should explore explanations for these findings and focus on solutions to deficiencies in care.
Authors: Judith H Lichtman; Lisa Naert; Norrina B Allen; Emi Watanabe; Sara B Jones; Lisa C Barry; Dawn M Bravata; Larry B Goldstein Journal: Circ Cardiovasc Qual Outcomes Date: 2010-11-23
Authors: Dawn M Bravata; Laura J Myers; Greg Arling; Edward J Miech; Teresa Damush; Jason J Sico; Michael S Phipps; Alan J Zillich; Zhangsheng Yu; Mathew Reeves; Linda S Williams; Jason Johanning; Seemant Chaturvedi; Fitsum Baye; Susan Ofner; Curt Austin; Jared Ferguson; Glenn D Graham; Rachel Rhude; Chad S Kessler; Donald S Higgins; Eric Cheng Journal: JAMA Neurol Date: 2018-04-01 Impact factor: 18.302
Authors: Judith A Hinchey; Timothy Shephard; Sarah T Tonn; Robin Ruthazer; Richard C Hermann; Harry P Selker; David M Kent Journal: J Stroke Cerebrovasc Dis Date: 2010-03 Impact factor: 2.136
Authors: M Patrice Lindsay; Moira K Kapral; David Gladstone; Robert Holloway; Jack V Tu; Andreas Laupacis; Jeremy M Grimshaw Journal: CMAJ Date: 2005-02-01 Impact factor: 8.262
Authors: M D I Vergouwen; J Fang; L K Casaubon; M K Kapral; M Stamplecoski; A Robertson; F L Silver Journal: AJNR Am J Neuroradiol Date: 2012-04-05 Impact factor: 3.825