Associations between the organisation of stroke services, process of care, and mortality in England: prospective cohort study

Abstract

Objective To estimate the relations between the organisation of stroke services, process measures of care quality, and 30 day mortality in patients admitted with acute ischaemic stroke.

Canadian Association of Emergency Physicians Position Statement on Acute Ischemic Stroke

“…6 In the inpatient setting, there is strong evidence that patients managed on organized inpatient stroke units have much better clinical outcomes. 7 Stroke unit care reduces the likelihood of death and disability in men and women of any age with mild, moderate, or severe stroke by as much as 30%. 8 Additionally, rapid assessment and management of patients with TIA also has strong evidence to its effectiveness.…”

“…Prehospital triage and transportation protocols should identify facilities locally or regionally designated to receive acute stroke patients and bypass more proximal facilities in favor of transporting to these sites, assuming the absence of other immediately life-threatening conditions (STRONG RECOMMENDATION, MODERATE QUALITY EVIDENCE). 5,7,10,11 2. Emergency departments that treat acute stroke patients should have "Code Stroke" protocols or stroke teams to rapidly assess, image and treat patients with the highest priority (STRONG RECOMMENDATION, MODERATE QUALITY EVIDENCE).…”

“…Designated stroke centers should be identified within regions to receive acute stroke patients; these centers should have organized inpatient (stroke unit) services (STRONG RECOMMENDATION, STRONG QUALITY EVIDENCE). 7,8,12 4. Telestroke networks should be established to provide access to stroke expertise for centers with limited local acute stroke resources as well as expertise in CT scan interpretation to exclude contraindications to lytic therapy (STRONG RECOMMENDATION, MODERATE QUALITY EVIDENCE).…”

Association between patient outcomes and key performance indicators of stroke care quality: A systematic review and meta-analysis

“…Antiplatelet drugs for ischemic stroke (IS) -Aspirin administration reported in two studies (25,43) was combined with a KPI for antiplatelet drugs for ischemic stroke reported in seven studies (17,18,21,23,24,28,40).…”

“…Early nurse/rehabilitation assessment -This combined indicator of early assessment by a nurse (24) and early assessment of rehabilitation needs (28).…”