International Comparison of Patient Characteristics and Quality of Care for Ischemic Stroke: Analysis of the China National Stroke Registry and the American Heart Association Get With The Guidelines-Stroke Program
机构：[1]Department of Neurology, Duke University Medical Center, Durham, NC[2]Clinical Research Center, Chinese Stroke Association, Beijing, China[3]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China重点科室诊疗科室神经病学中心神经病学中心首都医科大学附属天坛医院[4]Duke Clinical Research Institute, Durham, NC[5]Department of Neurology, University of California, Los Angeles, CA[6]Brigham and Women’s Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA[7]Hotchkiss Brain Institute, University of Calgary, Alberta, Canada[8]Stroke Service, Massachusetts General Hospital and Harvard Medical School, Boston, MA[9]Division of Cardiology, University of California, Los Angeles, CA
Background-Adherence to evidence-based guidelines is an important quality indicator; yet, there is lack of assessment of adherence to performance measures in acute ischemic stroke for most world regions. Methods and Results-We analyzed 19 604 patients with acute ischemic stroke in the China National Stroke Registry and 194 876 patients in the Get With The Guidelines-Stroke registry in the United States from June 2012 to January 2013. Compared with their US counterparts, Chinese patients were younger, had a lower prevalence of comorbidities, and had similar median, lower mean, and less variability in National Institutes of Health Stroke Scale (median 4 [25th percentile-75th percentile, 2-7], mean 5.4 +/- 5.6 versus median 4 [1-10], mean 6.8 +/- 7.7). Chinese patients were more likely to experience delays from last known well to hospital arrival (median 1318 [330-3209] versus 644 [142-2055] minutes), less likely to receive thrombolytic therapy (2.5% versus 8.1%), and more likely to experience treatment delays (door-to-needle time median 95 [72-112] versus 62 [49-85] minutes). Adherence to early and discharge antithrombotics, smoking cessation counseling, and dysphagia screening were relatively high (eg > 80%) in both countries. Large gaps existed between China and the United States with regard to the administration of thrombolytics within 3 hours (18.3% versus 83.6%), door-to-needle time <= 60 minutes (14.6% versus 48.0%), deep venous thrombosis prophylaxis (65.0% versus 97.8%), anticoagulation for atrial fibrillation (21.0% versus 94.4%), lipid treatment (66.3% versus 95.8%), and rehabilitation assessment (58.8% versus 97.4%). Conclusions-We found significant differences in clinical characteristics and gaps in adherence for certain performance measures between China and the United States. Additional efforts are needed for continued improvements in acute stroke care and secondary prevention in both nations, especially China.
基金：
Ministry of Science and TechnologyMinistry of Education, Culture, Sports, Science and Technology, Japan (MEXT); Ministry of Health of the People's Republic of China (National Key R&D Program of China) [2017YFC1310901, 2011BAI08B02, 2012ZX09303, 2013BAI09B14, 2013BAI09B03, 2015BAI12B02, 2015BAI12B04, 2016YFC0 901000, 2016YFC0901002, 2017YFC1310900, 2017YFC1310903, 2017YFC1307905]; National Key Technology Research and Development Program of the Ministry of Science and Technology of ChinaNational Key Technology R&D Program [2013BAI09B03]; Beijing Municipal Committee of Science and Technology [D15110700200000, D151100002015001, D151100002015002, Z161100000516223, Z141107 002514125]; Beijing Institute for Brain Disorders [BIBD-PXM2013_014226_07_000084]; National Institutes of Health, US Department of Health and Human ServicesUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [1D43-TW008308]; Janssen Pharmaceutical Companies of Johnson Johnson; Boehringer IngelheimBoehringer Ingelheim; MerckMerck & Company; Bristol-Myers Squibb/Sanofi Pharmaceutical PartnershipBristol-Myers Squibb; AHA Pharmaceutical RoundtableAmerican Heart Association
第一作者机构：[1]Department of Neurology, Duke University Medical Center, Durham, NC[2]Clinical Research Center, Chinese Stroke Association, Beijing, China[3]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China[*1]2400 Pratt Street, Durham, NC
通讯作者：
通讯机构：[1]Department of Neurology, Duke University Medical Center, Durham, NC[2]Clinical Research Center, Chinese Stroke Association, Beijing, China[3]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China[4]Duke Clinical Research Institute, Durham, NC[*1]2400 Pratt Street, Durham, NC
推荐引用方式(GB/T 7714)：
Runqi Wangqin,Daniel T. Laskowitz,Yongjun Wang,et al.International Comparison of Patient Characteristics and Quality of Care for Ischemic Stroke: Analysis of the China National Stroke Registry and the American Heart Association Get With The Guidelines-Stroke Program[J].JOURNAL OF THE AMERICAN HEART ASSOCIATION.2018,7(20):-.doi:10.1161/JAHA.118.010623.
APA：
Runqi Wangqin,Daniel T. Laskowitz,Yongjun Wang,Zixiao Li,Yilong Wang...&Ying Xian.(2018).International Comparison of Patient Characteristics and Quality of Care for Ischemic Stroke: Analysis of the China National Stroke Registry and the American Heart Association Get With The Guidelines-Stroke Program.JOURNAL OF THE AMERICAN HEART ASSOCIATION,7,(20)
MLA：
Runqi Wangqin,et al."International Comparison of Patient Characteristics and Quality of Care for Ischemic Stroke: Analysis of the China National Stroke Registry and the American Heart Association Get With The Guidelines-Stroke Program".JOURNAL OF THE AMERICAN HEART ASSOCIATION 7..20(2018):-
医学