Zachrison Kori S, Dhand Amar, Schwamm Lee H, Onnela Jukka-Pekka
Department of Emergency Medicine (K.S.Z.), Massachusetts General Hospital, Boston.
Department of Neurology, Brigham and Women's Hospital, Boston, MA (A.D.).
Circ Cardiovasc Qual Outcomes. 2019 Aug;12(8):e005526. doi: 10.1161/CIRCOUTCOMES.119.005526. Epub 2019 Aug 13.
The landscape of stroke systems of care is evolving as patients are increasingly transferred between hospitals for access to higher levels of care. This is driven by time-sensitive disability-reducing interventions such as mechanical thrombectomy. However, coordination and triage of patients for such treatment remain a challenge worldwide, particularly given complex eligibility criteria and varying time windows for treatment. Network analysis is an approach that may be applied to this problem. Hospital networks interlinked by patients moved from facility to facility can be studied using network modeling that respects the interdependent nature of the system. This allows understanding of the central hubs, the change of network structure over time, and the diffusion of innovations. This topical review introduces the basic principles of network science and provides an overview on the applications and potential interventions in stroke systems of care.
随着患者为获得更高水平的护理而越来越多地在医院之间转诊,中风护理系统的格局正在不断演变。这是由诸如机械取栓术等对时间敏感的减少残疾干预措施推动的。然而,对这类治疗患者的协调和分诊在全球范围内仍然是一项挑战,特别是考虑到复杂的资格标准和不同的治疗时间窗。网络分析是一种可应用于这个问题的方法。通过患者在不同机构之间转移而相互连接的医院网络,可以使用尊重系统相互依存性质的网络建模来进行研究。这有助于理解中心枢纽、网络结构随时间的变化以及创新的传播。本专题综述介绍了网络科学的基本原理,并概述了中风护理系统中的应用和潜在干预措施。