From the Department of Industrial Engineering, Dalhousie University, Halifax, Nova Scotia, Canada (N.K.).
Data Analytics, Alberta Health Services, Canada (E.R., J.S.).
Stroke. 2019 Jul;50(7):1883-1886. doi: 10.1161/STROKEAHA.119.024870. Epub 2019 Jun 3.
Background and Purpose- Endovascular therapy has been shown to be highly efficacious based on 90-day modified Rankin Scale score. We examined actual daily healthcare utilization from stroke onset to 1 year afterward from the ESCAPE trial (Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Time) and registry data. Methods- We examined patients from Alberta, Canada, that was enrolled into the ESCAPE trial and the Quality Improvement and Clinical Research registry in the 2016/2017 fiscal year. Through data linkages to several administrative data sets, the daily location of each patient was assessed in various healthcare settings. Results- A total of 286 patients were analyzed, 52 patients were in the treatment arm, and 47 patients were in the control arm of the ESCAPE trial while 187 patients received endovascular therapy as usual care (2016/2017 fiscal year). The odds of a patient being out of a healthcare setting over 1 year was significantly higher when they received endovascular therapy: 3.46 (1.68-7.30) in ESCAPE trial patients and 2.00 (1.08-3.75) in the Quality Improvement And Clinical Research patients. Conclusions- Endovascular therapy significantly reduces healthcare utilization up to 1 year after a stroke.
背景与目的-基于 90 天改良 Rankin 量表评分，血管内治疗已被证明具有高度疗效。我们从 ESCAPE 试验（小核心和前循环近端闭塞的血管内治疗，重点是最小化 CT 再通时间）和登记数据中检查了从发病到 1 年后实际的日常医疗保健利用情况。方法-我们检查了 2016/2017 财年在加拿大阿尔伯塔省入组 ESCAPE 试验和质量改进与临床研究登记处的患者。通过与多个行政数据集的数据链接，评估了每位患者在各种医疗保健环境中的日常位置。结果-共分析了 286 名患者，其中 52 名患者在 ESCAPE 试验的治疗组，47 名患者在 ESCAPE 试验的对照组，187 名患者接受了血管内治疗作为常规治疗（2016/2017 财年）。当患者接受血管内治疗时，他们在 1 年以上时间内离开医疗保健环境的可能性显著增加：在 ESCAPE 试验患者中为 3.46（1.68-7.30），在质量改进和临床研究患者中为 2.00（1.08-3.75）。结论-血管内治疗可显著降低中风后 1 年内的医疗保健利用。
