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Age and gender variations in the management of ischaemic stroke in China
Yining Huang1, Ji-Guang Wang, Jade W Wei
1Department of Neurology, Peking University First Hospital, Beijing, China.
Insights
Stroke management in China involves high use of traditional Chinese medicine and neuroprotectants, with long hospital stays. Care variations by age were observed, but not significantly by gender.
Area of Science:
- Neurology
- Public Health
- Healthcare Management
Background:
- Stroke represents a significant public health challenge in China.
- Understanding current management practices is crucial for improving patient outcomes.
Purpose of the Study:
- To characterize the management of acute ischemic stroke patients in Chinese hospitals.
- To investigate potential disparities in stroke care based on patient age and gender.
Main Methods:
- A multicenter prospective hospital register was utilized across China's eight major economic regions.
- Data collected included patient demographics, medical history, clinical presentation, investigations, treatments, and outcomes.
- The study focused on consecutive patients with acute ischemic stroke over a 5-month period in 2006.
Main Results:
- High utilization of traditional Chinese medicine (nearly 80%) and neuroprotectants (over 70%) was observed.
- The median hospital stay was prolonged at 16 days.
- While gender showed no significant management differences, increasing age correlated with reduced use of thrombolysis, warfarin, corticosteroids, and lipid-lowering therapy, alongside increased assisted feeding and higher complication rates.
Conclusions:
- This study offers current insights into ischemic stroke management in China.
- Key findings include prevalent use of traditional Chinese medicine and neuroprotectants, and extended hospitalizations.
- Minor age- and gender-related variations in stroke care mirror those seen globally.
Background:
Stroke is a major health issue in China.
Aims:
We aimed to describe the management of patients admitted to hospitals in China with acute ischaemic stroke, and to determine whether there were any differences by age and gender.
Methods:
Using a multicentre prospective hospital register across all eight major economic (geographic) regions in China, data on the socioeconomic characteristics, medical history, clinical features, and in-hospital investigations, management, and outcomes were collected on consecutive patients with acute stroke due to cerebral ischaemia during a 5-month period in 2006.
Results:
Overall, traditional Chinese medicine and neuroprotectant use were remarkably high, with nearly 80% of patients receiving the former and >70% receiving the latter in hospital. Length of hospital stay was also long (median duration 16-days). Multivariate analyses revealed no clinically important differences in management between the genders. For the age-specific analyses, there were significant trends of decreasing use of thrombolysis (P=0·04), warfarin (P=0·01), corticosteroids (P=0·03), and lipid-lowering therapy (P=0·001); however, more assisted feeding (P=0·004) and rising rates of disability and in-hospital complications occurred with increasing age.
Conclusions:
New information is provided regarding the current state of ischaemic stroke management in China. Notably, there is high use of traditional Chinese medicine and neuroprotectants and long lengths of hospital stay. Similar to many other countries, differences in stroke care and management by age and gender also exist to a small extent in China.
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