The Lombardia Stroke Unit Registry: 1-year experience of a web-based hospital stroke registry

Micieli, Giuseppe; Cavallini, Anna; Quaglini, Silvana; Fontana, Giancarlo; Duè, Michela

doi:10.1007/s10072-010-0249-x

Cited by 9 publications

(5 citation statements)

References 33 publications

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“…All patients, or relatives, gave written informed consent to the SUN epidemiological survey, that was previously approved by the local health care authorities (Regione Lombardia) as a permanent diseases registry. 16 , 17 …”

Section: Methodsmentioning

confidence: 99%

Airborne pollutants and lacunar stroke: a case cross-over analysis on stroke unit admissions

et al. 2012

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Particulate air pollution is known to be associated with cardiovascular disease. The relation of particulate air pollution with cerebrovascular disease (CVD) has not been extensively studied, particularly in relation to different subtypes of stroke. A time-series study was conducted to evaluate the association between daily air pollution and acute stroke unit hospitalizations in Mantua, Italy. We analyzed 781 CVD consecutive patients living in Mantua county admitted between 2006–08. Data on stroke types, demographic variables, risk factors were available from the Lombardia Stroke Registry. Daily mean value of particulate matter with a diameter <10 µm (PM10), carbon monoxide, nitric oxide, nitrogen dioxide, sulphur dioxide, benzene and ozone were used in the analysis. The association between CVD, ischemic strokes subtypes and pollutants was investigated with a case-crossover design, using conditional logistic regression analysis, adjusting for temperature, humidity, barometric pressure and holidays. Among the 781 subjects admitted 75.7% had ischemic stroke, 11.7% haemorrhagic stroke 12.6% transient ischemic attack. In men admission for stroke was associated with PM10 [odds ratio (OR) 1.01, 95%; confidence interval (CI) 1.00–1.02; P<0.05]. According to the clinical classification, lacunar anterior circulation syndrome stroke type was related to PM10 level registered on the day of admission for both genders (OR: 1.01, 95%; CI: 1.00–1.02; P<0.05) while for total anterior circulation syndrome stroke only in men (OR: 1.04, 95%; CI 1.01–1.07; P<0.05).In conclusion, our study confirms that air pollution peaks may contribute to increase the risk of hospitalization for stroke and particulate matter seems to be a significant risk factor, especially for lacunar stroke.

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Section: Methodsmentioning

confidence: 99%

Airborne pollutants and lacunar stroke: a case cross-over analysis on stroke unit admissions

et al. 2012

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“…The aim of this study is to identify the clinical factors influencing statin prescription by physicians in acute ischemic stroke patients at discharge from Lombardia Stroke Units [24]. We analyzed data collected from a web-based registry: the Lombardia Stroke Registry (LSR), describing the activity of our region’s Stroke Units.…”

Section: Introductionmentioning

confidence: 99%

Clinical factors associated with statins prescription in acute ischemic stroke patients: findings from the Lombardia Stroke Registry

et al. 2014

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BackgroundStatins, due to their well-established pleiotropic effects, have noteworthy benefits in stroke prevention. Despite this, a significant proportion of high-risk patients still do not receive the recommended therapeutic regimens, and many others discontinue treatment after being started on them. The causes of non-adherence to current guidelines are multifactorial, and depend on both physicians and patients. The aim of this study is to identify the factors influencing statin prescription at Stroke Unit (SU) discharge.MethodsThis study included 12,750 patients enrolled on the web-based Lombardia Stroke Registry (LRS) from July 2009 to April 2012 and discharged alive, with a diagnosis of ischemic stroke or transient ischemic attack (TIA) and without contra-indication to statin therapy. By logistic regression analysis and classification trees, we evaluated the impact of demographic data, risk factors, tPA treatment, in-hospital procedures and complications on statin prescription rate at discharge.ResultsWe observed a slight increase in statins prescription during the study period (from 39.1 to 43.9%). Lower age, lower stroke severity and prestroke disability, the presence of atherothrombotic/lacunar risk factors, a diagnosis of non-cardioembolic stroke, tPA treatment, the absence of in-hospital complications, with the sole exception of hypertensive fits and hyperglycemia, were the patient-related predictors of adherence to guidelines by physicians. Overall, dyslipidemia appears as the leading factor, while TOAST classification does not reach statistical significance.ConclusionsIn our region, Lombardia, adherence to guidelines in statin prescription at Stroke Unit discharge is very different from international goals. The presence of dyslipidemia remains the main factor influencing statin prescription, while the presence of well-defined atherosclerotic etiopathogenesis of stroke does not enhance statin prescription. Some uncertainties about the risk/benefit of statin therapy in stroke etiology subtypes (cardioembolism, other or undetermined causes) may partially justify the underuse of statin in ischemic stroke. The differences that exist between current international guidelines may prevent a more widespread use of statin and should be clarified in a consensus.

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“…The extensive use of free text data was a further limitation to the possible statistics. Thus, the accomplishment of the study has required a careful data cleaning and pre-processing, before the effectiveness of the registry could be shown [18]. Moreover, the website only provided the data entry Graphical User Interface (GUI) and a data export facility in terms of a flat spreadsheet format, so that statistics or reports were neither immediately available to the end users nor even to the registry coordinator.…”

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confidence: 99%

Data Quality and Completeness in a Web Stroke Registry as the Basis for Data and Process Mining

Lanzola

Parimbelli

Micieli

et al. 2014

Journal of Healthcare Engineering

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Electronic health records often show missing values and errors jeopardizing their effective exploitation. We illustrate the re-engineering process needed to improve the data quality of a web-based, multicentric stroke registry by proposing a knowledge-based data entry support able to help users to homogeneously interpret data items, and to prevent and detect treacherous errors. The re-engineering also improves stroke units coordination and networking, through ancillary tools for monitoring patient enrollments, calculating stroke care indicators, analyzing compliance with clinical practice guidelines, and entering stroke units profiles. Finally we report on some statistics, such as calculation of indicators for assessing the quality of stroke care, data mining for knowledge discovery, and process mining for comparing different processes of care delivery. The most important results of the re-engineering are an improved user experience with data entry, and a definitely better data quality that guarantees the reliability of data analyses.

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The Lombardia Stroke Unit Registry: 1-year experience of a web-based hospital stroke registry

Cited by 9 publications

References 33 publications

Airborne pollutants and lacunar stroke: a case cross-over analysis on stroke unit admissions

Airborne pollutants and lacunar stroke: a case cross-over analysis on stroke unit admissions

Clinical factors associated with statins prescription in acute ischemic stroke patients: findings from the Lombardia Stroke Registry

Data Quality and Completeness in a Web Stroke Registry as the Basis for Data and Process Mining

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