TY - JOUR
T1 - The impact of comprehensive stroke care capacity on the hospital volume of stroke interventions
T2 - A nationwide study in Japan: J-aspect study
AU - Iihara, Koji
AU - Nishimura, Kunihiro
AU - Kada, Akiko
AU - Nakagawara, Jyoji
AU - Toyoda, Kazunori
AU - Ogasawara, Kuniaki
AU - Ono, Junichi
AU - Shiokawa, Yoshiaki
AU - Aruga, Toru
AU - Miyachi, Shigeru
AU - Nagata, Izumi
AU - Matsuda, Shinya
AU - Ishikawa, Koichi B.
AU - Suzuki, Akifumi
AU - Mori, Hisae
AU - Nakamura, Fumiaki
PY - 2014
Y1 - 2014
N2 - The association between comprehensive stroke care capacity and hospital volume of stroke interventions remains uncertain. We performed a nationwide survey in Japan to examine the impact of comprehensive stroke care capacity on the hospital volume of stroke interventions. Methods: A questionnaire on hospital characteristics, having tissue plasminogen activator (t-PA) protocols, and 25 items regarding personnel, diagnostic, specific expertise, infrastructure, and educational components recommended for comprehensive stroke centers (CSCs) was sent to 1369 professional training institutions. We examined the effect of hospital characteristics, having a t-PA protocol, and the number of fulfilled CSC items (total CSC score) on the hospital volume of t-PA infusion, removal of intracerebral hemorrhage, and coiling and clipping of intracranial aneurysms performed in 2009. Results: Approximately 55% of hospitals responded to the survey. Facilities with t-PA protocols (85%) had a significantly higher likelihood of having 23 CSC items, for example, personnel (eg, neurosurgeons: 97.3% versus 66.1% and neurologists: 51.3% versus 27.7%), diagnostic (eg, digital cerebral angiography: 87.4% versus 43.2%), specific expertise (eg, clipping and coiling: 97.2% and 54% versus 58.9% and 14.3%, respectively), infrastructure (eg, intensive care unit: 63.9% versus 33.9%), and education (eg, professional education: 65.2% versus 20.7%). On multivariate analysis adjusted for hospital characteristics, total CSC score, but not having a t-PA protocol, was associated with the volume of all types of interventions with a clear increasing trend (P for trend <.001). Conclusion: We demonstrated a significant association between comprehensive stroke care capacity and the hospital volume of stroke interventions in Japan.
AB - The association between comprehensive stroke care capacity and hospital volume of stroke interventions remains uncertain. We performed a nationwide survey in Japan to examine the impact of comprehensive stroke care capacity on the hospital volume of stroke interventions. Methods: A questionnaire on hospital characteristics, having tissue plasminogen activator (t-PA) protocols, and 25 items regarding personnel, diagnostic, specific expertise, infrastructure, and educational components recommended for comprehensive stroke centers (CSCs) was sent to 1369 professional training institutions. We examined the effect of hospital characteristics, having a t-PA protocol, and the number of fulfilled CSC items (total CSC score) on the hospital volume of t-PA infusion, removal of intracerebral hemorrhage, and coiling and clipping of intracranial aneurysms performed in 2009. Results: Approximately 55% of hospitals responded to the survey. Facilities with t-PA protocols (85%) had a significantly higher likelihood of having 23 CSC items, for example, personnel (eg, neurosurgeons: 97.3% versus 66.1% and neurologists: 51.3% versus 27.7%), diagnostic (eg, digital cerebral angiography: 87.4% versus 43.2%), specific expertise (eg, clipping and coiling: 97.2% and 54% versus 58.9% and 14.3%, respectively), infrastructure (eg, intensive care unit: 63.9% versus 33.9%), and education (eg, professional education: 65.2% versus 20.7%). On multivariate analysis adjusted for hospital characteristics, total CSC score, but not having a t-PA protocol, was associated with the volume of all types of interventions with a clear increasing trend (P for trend <.001). Conclusion: We demonstrated a significant association between comprehensive stroke care capacity and the hospital volume of stroke interventions in Japan.
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U2 - 10.1016/j.jstrokecerebrovasdis.2013.08.016
DO - 10.1016/j.jstrokecerebrovasdis.2013.08.016
M3 - Article
C2 - 24103675
AN - SCOPUS:84901373122
SN - 1052-3057
VL - 23
SP - 1001
EP - 1018
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
IS - 5
ER -