Korukcu Merve, Eren Alper
Department of Neurology, Ardahan State Hospital, Ardahan, Türkiye.
Department of Neurology, Ataturk University Faculty of Medicine, Erzurum, Türkiye.
Eurasian J Med. 2024 Oct 23;56(3):182-188. doi: 10.5152/eurasianjmed.2024.24554.
The stroke center approach provides an efective solution for acute stroke management. Our study aims to systematically analyze our stroke center records to identify factors that afect acute stroke time-sensitive quality metrics. Data were prospectively collected from 524 acute stroke patients at the Comprehensive Stroke Center of Atatürk UniversityMedical Faculty Hospital between January 1, 2021, and September 30, 2021. Data collected included sociodemographic, clinical, admission type, initial National Institutes of Health Stroke Scale (NIHSS), treatment modality, and time-sensitive metrics and were statistically analyzed based on stroke quality metrics. Patients with mild NIHSS scores (0-7) had longer onset-to-door (OTD) time, door-to-computed tomography (CT)/neurologist, and hospitalization times (P < .001). The OTD, door-to-CT/neurologist, and hospitalization times varied depending on the treatment methods used (P < .005). The OTD time was influenced by the patient's level of education (P=.004), admission type (P < .001), and geographical location (P=.002). A moderate negative correlation was found between patients' OTD time and baseline NIHSS (r=-0.270; P < 0.001). The results emphasize the significance of several factors, such as admission type, geographical location, and treatment methods, in shaping the time-sensitive quality metrics of stroke care. Additionally, the initial NIHSS score of patients plays a crucial role in both prehospital and in-hospital aspects of acute stroke management.
卒中中心模式为急性卒中管理提供了有效的解决方案。我们的研究旨在系统分析卒中中心的记录，以确定影响急性卒中时间敏感质量指标的因素。前瞻性收集了2021年1月1日至2021年9月30日期间在阿塔图尔克大学医学院综合卒中中心的524例急性卒中患者的数据。收集的数据包括社会人口统计学、临床、入院类型、初始美国国立卫生研究院卒中量表（NIHSS）、治疗方式以及时间敏感指标，并根据卒中质量指标进行了统计分析。NIHSS评分较低（0 - 7分）的患者从发病到入院（OTD）时间、入院到计算机断层扫描（CT）/神经科医生的时间以及住院时间更长（P < 0.001）。OTD、入院到CT/神经科医生的时间以及住院时间因所采用的治疗方法而异（P < 0.005）。OTD时间受患者教育程度（P = 0.004）、入院类型（P < 0.001）和地理位置（P = 0.002）的影响。患者的OTD时间与基线NIHSS之间存在中度负相关（r = -0.270；P < 0.001）。结果强调了入院类型、地理位置和治疗方法等几个因素在塑造卒中护理时间敏感质量指标方面的重要性。此外，患者的初始NIHSS评分在急性卒中管理的院前和院内方面都起着关键作用。
