Regional variation in acute stroke care organisation

Paula Muñoz Venturelli; Thompson Robinson; Pablo M. Lavados; Verónica V. Olavarría; Hisatomi Arima; Laurent Billot; Maree L. Hackett; Joyce Y. Lim; Sandy Middleton; Octavio Pontes-Neto; Bin Peng; Liying Cui; Lily Song; Gillian Mead; Caroline Watkins; Ruey Tay Lin; Tsong Hai Lee; Jeyaraj Pandian; H. Asita de Silva; Craig S. Anderson

doi:10.1016/j.jns.2016.10.026

Regional variation in acute stroke care organisation

Paula Muñoz Venturelli, Thompson Robinson, Pablo M. Lavados, Verónica V. Olavarría, Hisatomi Arima, Laurent Billot, Maree L. Hackett, Joyce Y. Lim, Sandy Middleton, Octavio Pontes-Neto, Bin Peng, Liying Cui, Lily Song, Gillian Mead, Caroline Watkins, Ruey Tay Lin, Tsong Hai Lee, Jeyaraj Pandian, H. Asita de Silva, Craig S. Anderson^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Background 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

Original language	English
Pages (from-to)	126-130
Number of pages	5
Journal	Journal of the Neurological Sciences
Volume	371
Early online date	18 Oct 2016
DOIs	https://doi.org/10.1016/j.jns.2016.10.026
Publication status	Published - 15 Dec 2016

Keywords / Materials (for Non-textual outputs)

Acute ischemic stroke
In- and out-hospital stroke care organisation
Intracerebral hemorrhage
Stroke
Stroke care
Thrombolysis

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10.1016/j.jns.2016.10.026

http://clok.uclan.ac.uk/16125/Licence: Creative Commons: Attribution-NonCommercial-NoDerivatives (CC BY-NC-ND)

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Muñoz Venturelli, P., Robinson, T., Lavados, P. M., Olavarría, V. V., Arima, H., Billot, L., Hackett, M. L., Lim, J. Y., Middleton, S., Pontes-Neto, O., Peng, B., Cui, L., Song, L., Mead, G., Watkins, C., Lin, R. T., Lee, T. H., Pandian, J., de Silva, H. A., & Anderson, C. S. (2016). Regional variation in acute stroke care organisation. Journal of the Neurological Sciences, 371, 126-130. https://doi.org/10.1016/j.jns.2016.10.026

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title = "Regional variation in acute stroke care organisation",

abstract = "Background 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 {\textquoteleft}sitting-up{\textquoteright} versus {\textquoteleft}lying-flat{\textquoteright} 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 ",

keywords = "Acute ischemic stroke, In- and out-hospital stroke care organisation, Intracerebral hemorrhage, Stroke, Stroke care, Thrombolysis",

author = "{Mu{\~n}oz Venturelli}, Paula and Thompson Robinson and Lavados, {Pablo M.} and Olavarr{\'i}a, {Ver{\'o}nica V.} and Hisatomi Arima and Laurent Billot and Hackett, {Maree L.} and Lim, {Joyce Y.} and Sandy Middleton and Octavio Pontes-Neto and Bin Peng and Liying Cui and Lily Song and Gillian Mead and Caroline Watkins and Lin, {Ruey Tay} and Lee, {Tsong Hai} and Jeyaraj Pandian and {de Silva}, {H. Asita} and Anderson, {Craig S.}",

year = "2016",

month = dec,

day = "15",

doi = "10.1016/j.jns.2016.10.026",

language = "English",

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journal = "Journal of the Neurological Sciences",

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Muñoz 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 2016, 'Regional variation in acute stroke care organisation', Journal of the Neurological Sciences, vol. 371, pp. 126-130. https://doi.org/10.1016/j.jns.2016.10.026

TY - JOUR

T1 - Regional variation in acute stroke care organisation

AU - Muñoz Venturelli, Paula

AU - Robinson, Thompson

AU - Lavados, Pablo M.

AU - Olavarría, Verónica V.

AU - Arima, Hisatomi

AU - Billot, Laurent

AU - Hackett, Maree L.

AU - Lim, Joyce Y.

AU - Middleton, Sandy

AU - Pontes-Neto, Octavio

AU - Peng, Bin

AU - Cui, Liying

AU - Song, Lily

AU - Mead, Gillian

AU - Watkins, Caroline

AU - Lin, Ruey Tay

AU - Lee, Tsong Hai

AU - Pandian, Jeyaraj

AU - de Silva, H. Asita

AU - Anderson, Craig S.

PY - 2016/12/15

Y1 - 2016/12/15

N2 - Background 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

AB - Background 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

KW - Acute ischemic stroke

KW - In- and out-hospital stroke care organisation

KW - Intracerebral hemorrhage

KW - Stroke

KW - Stroke care

KW - Thrombolysis

UR - http://www.scopus.com/inward/record.url?scp=84992549134&partnerID=8YFLogxK

U2 - 10.1016/j.jns.2016.10.026

DO - 10.1016/j.jns.2016.10.026

M3 - Article

AN - SCOPUS:84992549134

SN - 0022-510X

VL - 371

SP - 126

EP - 130

JO - Journal of the Neurological Sciences

JF - Journal of the Neurological Sciences

ER -

Regional variation in acute stroke care organisation

Abstract

Keywords / Materials (for Non-textual outputs)

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