Stroke Center Care and Outcome: Results from the CSPPC Stroke Program

Area of Science:

• Neurology
• Public Health
• Health Services Research

Background:

• Acute ischemic stroke requires timely and specialized care to minimize complications and mortality.
• The role of dedicated stroke centers in managing acute ischemic stroke patients in China is an area of ongoing investigation.
• Optimizing patient pathways and hospital resources is crucial for improving stroke care outcomes.

Purpose of the Study:

• To evaluate the association between admission to stroke centers versus non-stroke centers for acute ischemic stroke.
• To compare in-hospital complications and mortality rates between stroke center (SH) and non-stroke center (CH) hospitals.
• To assess the impact of stroke center care on patients receiving thrombolytic therapy.

Main Methods:

• Observational study utilizing data from the China Stroke Center Data-Sharing Platform.
• Comparison of 13,236 acute ischemic stroke patients admitted between November 1, 2018, and December 31, 2018.
• Instrumental variable analysis using hospital proximity to mitigate prehospital selection bias.

Main Results:

• Stroke center admission was linked to significantly lower complication rates (11.1% vs. 15.7%) among patients receiving thrombolytic therapy.
• The incidence of intracranial hemorrhage was reduced in the stroke center group (3.2% vs. 4.2%).
• Total mortality rates were lower in the stroke center group (2.2% vs. 3.0%) compared to non-stroke centers.

Conclusions:

• Admission to stroke centers is associated with a reduced risk of treatment complications for acute ischemic stroke patients.
• Stroke center care demonstrates a significant association with lower mortality rates in acute ischemic stroke patients.
• These findings underscore the importance of specialized stroke center networks for improving acute ischemic stroke management and patient outcomes.