Evaluation of Off-Hour Emergency Care in Acute Ischemic Stroke: Results from the China National Stroke Registry
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{"title"=>"Evaluation of off-hour emergency care in acute ischemic stroke: Results from the China national stroke registry", "type"=>"journal", "authors"=>[{"first_name"=>"Guifen", "last_name"=>"Wang", "scopus_author_id"=>"56937197300"}, {"first_name"=>"Gaifen", "last_name"=>"Liu", "scopus_author_id"=>"8919002300"}, {"first_name"=>"Runhua", "last_name"=>"Zhang", "scopus_author_id"=>"56344349100"}, {"first_name"=>"Ruijun", "last_name"=>"Ji", "scopus_author_id"=>"35962536500"}, {"first_name"=>"Baoqin", "last_name"=>"Gao", "scopus_author_id"=>"16833595400"}, {"first_name"=>"Yilong", "last_name"=>"Wang", "scopus_author_id"=>"36553742800"}, {"first_name"=>"Yuesong", "last_name"=>"Pan", "scopus_author_id"=>"55508666300"}, {"first_name"=>"Zixiao", "last_name"=>"Li", "scopus_author_id"=>"27168415300"}, {"first_name"=>"Yongjun", "last_name"=>"Wang", "scopus_author_id"=>"8320879700"}], "year"=>2015, "source"=>"PLoS ONE", "identifiers"=>{"doi"=>"10.1371/journal.pone.0138046", "sgr"=>"84945961304", "pui"=>"606624571", "scopus"=>"2-s2.0-84945961304", "issn"=>"19326203", "pmid"=>"26379280", "isbn"=>"1932-6203"}, "id"=>"636104a7-55fc-39b2-b246-70a5cbad908e", "abstract"=>"BACKGROUND AND PURPOSE: The quality of after-hour emergency care of patients with acute ischemic stroke is debatable. We therefore, sought to analyze the performance measures, quality of care and clinical outcomes in these patients admitted during off-hours.\\n\\nMETHODS: Our study included 4493 patients from a selected cohort of patients admitted to the hospitals with ischemic stroke in the China National Stroke Registry (CNSR) from September 2007 to August 2008. On-hour presentation was defined as arrival at the emergency department from the scene between 8AM and 5PM from Monday through Friday. Off-hours included the remainder of the on-hours and statutory holidays. The association between off-hour presentation and outcome was analyzed using multivariate logistic-regression models.\\n\\nRESULTS: Off-hour presentation was identified in 2672 (59.5%) patients with ischemic stroke. Comparison of patients admitted during off-hours with those admitted during on-hours revealed an unadjusted odds ratio of in-hospital mortality of 1.38 (95% confidence interval, 1.04-1.85), which declined to 1.34 (95% confidence interval, 0.93-1.93) after adjusting for patient characteristics (especially, pre-hospital delay). No difference in 30-day mortality, total death or dependence at three, six and 12 months between two groups was observed. No association between off-hour admission and quality of care was found.\\n\\nCONCLUSIONS: In the CNSR database, compared with on-hour patients, off-hour patients with acute ischemic stroke admitted to the emergency departments from scene manifested a higher incidence of in-hospital mortality. However, the difference in incidence and quality of care between the groups disappeared after adjusting for pre-hospital delay and other variables.", "link"=>"http://www.mendeley.com/research/evaluation-offhour-emergency-care-acute-ischemic-stroke-results-china-national-stroke-registry-1", "reader_count"=>10, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Librarian"=>1, "Researcher"=>1, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>1, "Other"=>1, "Student > Master"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Librarian"=>1, "Researcher"=>1, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>1, "Other"=>1, "Student > Master"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>2, "Engineering"=>1, "Medicine and Dentistry"=>4, "Agricultural and Biological Sciences"=>1, "Social Sciences"=>1, "Computer Science"=>1}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>4}, "Social Sciences"=>{"Social Sciences"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Computer Science"=>{"Computer Science"=>1}, "Unspecified"=>{"Unspecified"=>2}}, "group_count"=>2}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/2269603", "https://ndownloader.figshare.com/files/2269604", "https://ndownloader.figshare.com/files/2269605"], "description"=>"<div><p>Background and Purpose</p><p>The quality of after-hour emergency care of patients with acute ischemic stroke is debatable. We therefore, sought to analyze the performance measures, quality of care and clinical outcomes in these patients admitted during off-hours.</p><p>Methods</p><p>Our study included 4493 patients from a selected cohort of patients admitted to the hospitals with ischemic stroke in the China National Stroke Registry (CNSR) from September 2007 to August 2008. On-hour presentation was defined as arrival at the emergency department from the scene between 8AM and 5PM from Monday through Friday. Off-hours included the remainder of the on-hours and statutory holidays. The association between off-hour presentation and outcome was analyzed using multivariate logistic-regression models.</p><p>Results</p><p>Off-hour presentation was identified in 2672 (59.5%) patients with ischemic stroke. Comparison of patients admitted during off-hours with those admitted during on-hours revealed an unadjusted odds ratio of in-hospital mortality of 1.38 (95% confidence interval, 1.04–1.85), which declined to 1.34 (95% confidence interval, 0.93–1.93) after adjusting for patient characteristics (especially, pre-hospital delay). No difference in 30-day mortality, total death or dependence at three, six and 12 months between two groups was observed. No association between off-hour admission and quality of care was found.</p><p>Conclusions</p><p>In the CNSR database, compared with on-hour patients, off-hour patients with acute ischemic stroke admitted to the emergency departments from scene manifested a higher incidence of in-hospital mortality. However, the difference in incidence and quality of care between the groups disappeared after adjusting for pre-hospital delay and other variables.</p></div>", "links"=>[], "tags"=>["Ischemic stroke", "Acute Ischemic Stroke", "CNSR", "pm", "China National Stroke Registry", "am", "China National Stroke Registry Background"], "article_id"=>1547582, "categories"=>["Uncategorised"], "users"=>["Guifen Wang", "Gaifen Liu", "Runhua Zhang", "Ruijun Ji", "Baoqin Gao", "Yilong Wang", "Yuesong Pan", "Zixiao Li", "Yongjun Wang"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0138046.s001", "https://dx.doi.org/10.1371/journal.pone.0138046.s002", "https://dx.doi.org/10.1371/journal.pone.0138046.s003"], "stats"=>{"downloads"=>4, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Evaluation_of_Off_Hour_Emergency_Care_in_Acute_Ischemic_Stroke_Results_from_the_China_National_Stroke_Registry_/1547582", "title"=>"Evaluation of Off-Hour Emergency Care in Acute Ischemic Stroke: Results from the China National Stroke Registry", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2015-09-17 03:43:18"}
  • {"files"=>["https://ndownloader.figshare.com/files/2269600"], "description"=>"<p>Abbreviations: DVT, deep vein thrombosis; AF, atrial fibrillation; (n/N, %): n, of adherence; N, of eligible; %, Adherence rate.</p><p>Quality of Care Indicators and Off-hour vs On-hour Presentation after Ischemic Stroke.</p>", "links"=>[], "tags"=>["Ischemic stroke", "Acute Ischemic Stroke", "CNSR", "pm", "China National Stroke Registry", "am", "China National Stroke Registry Background"], "article_id"=>1547579, "categories"=>["Uncategorised"], "users"=>["Guifen Wang", "Gaifen Liu", "Runhua Zhang", "Ruijun Ji", "Baoqin Gao", "Yilong Wang", "Yuesong Pan", "Zixiao Li", "Yongjun Wang"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0138046.t002", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Quality_of_Care_Indicators_and_Off_hour_vs_On_hour_Presentation_after_Ischemic_Stroke_/1547579", "title"=>"Quality of Care Indicators and Off-hour vs On-hour Presentation after Ischemic Stroke.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-09-17 03:43:18"}
  • {"files"=>["https://ndownloader.figshare.com/files/2269599"], "description"=>"<p>Abbreviations: SD, standard deviation; BMI, body-mass index; IQR, interquartile range; TIA, transient ischemic attack; mRS, modified Rankin Scale; NIHSS, National Institutes of Health Stroke Scale; OCSP, Oxfordshire Community Stroke Project criteria; PACI, partial anterior circulation infarct; TACI, total anterior circulation infarct; LACI, lacunar infarct; POCI, posterior circulation infarct; IV rtPA, intravenous recombinant tissue plasminogen activator.</p><p>Baseline Characteristics of Patients Admitted to the Emergency Departments between On-hour and Off-hour Presentations after Ischemic Stroke.</p>", "links"=>[], "tags"=>["Ischemic stroke", "Acute Ischemic Stroke", "CNSR", "pm", "China National Stroke Registry", "am", "China National Stroke Registry Background"], "article_id"=>1547578, "categories"=>["Uncategorised"], "users"=>["Guifen Wang", "Gaifen Liu", "Runhua Zhang", "Ruijun Ji", "Baoqin Gao", "Yilong Wang", "Yuesong Pan", "Zixiao Li", "Yongjun Wang"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0138046.t001", "stats"=>{"downloads"=>2, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Baseline_Characteristics_of_Patients_Admitted_to_the_Emergency_Departments_between_On_hour_and_Off_hour_Presentations_after_Ischemic_Stroke_/1547578", "title"=>"Baseline Characteristics of Patients Admitted to the Emergency Departments between On-hour and Off-hour Presentations after Ischemic Stroke.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-09-17 03:43:18"}
  • {"files"=>["https://ndownloader.figshare.com/files/2269602"], "description"=>"<p>Abbreviations: OR, odds ratio; CI, confidence interval. Adjusted for age, sex, National Institutes of Health Stroke Scale, smoking, drinking, hypertension, coronary heart disease, atrial fibrillation, diabetes mellitus, dyslipidemia, IV rtPA, and time from onset to admission within three hours (pre-hospital delay).</p><p>Unadjusted and Adjusted Odds Ratios of Poor Outcomes in Ischemic Stroke Patients: Off-hour versus On-hour Presentations.</p>", "links"=>[], "tags"=>["Ischemic stroke", "Acute Ischemic Stroke", "CNSR", "pm", "China National Stroke Registry", "am", "China National Stroke Registry Background"], "article_id"=>1547581, "categories"=>["Uncategorised"], "users"=>["Guifen Wang", "Gaifen Liu", "Runhua Zhang", "Ruijun Ji", "Baoqin Gao", "Yilong Wang", "Yuesong Pan", "Zixiao Li", "Yongjun Wang"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0138046.t004", "stats"=>{"downloads"=>1, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Unadjusted_and_Adjusted_Odds_Ratios_of_Poor_Outcomes_in_Ischemic_Stroke_Patients_Off_hour_versus_On_hour_Presentations_/1547581", "title"=>"Unadjusted and Adjusted Odds Ratios of Poor Outcomes in Ischemic Stroke Patients: Off-hour versus On-hour Presentations.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-09-17 03:43:18"}
  • {"files"=>["https://ndownloader.figshare.com/files/2269601"], "description"=>"<p>Comparison of Patient Outcomes between On-hour and Off-hour Presentations after Ischemic Stroke.</p>", "links"=>[], "tags"=>["Ischemic stroke", "Acute Ischemic Stroke", "CNSR", "pm", "China National Stroke Registry", "am", "China National Stroke Registry Background"], "article_id"=>1547580, "categories"=>["Uncategorised"], "users"=>["Guifen Wang", "Gaifen Liu", "Runhua Zhang", "Ruijun Ji", "Baoqin Gao", "Yilong Wang", "Yuesong Pan", "Zixiao Li", "Yongjun Wang"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0138046.t003", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Comparison_of_Patient_Outcomes_between_On_hour_and_Off_hour_Presentations_after_Ischemic_Stroke_/1547580", "title"=>"Comparison of Patient Outcomes between On-hour and Off-hour Presentations after Ischemic Stroke.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-09-17 03:43:18"}
  • {"files"=>["https://ndownloader.figshare.com/files/2269598"], "description"=>"<p>Clinical characteristics of the analyzed population (n = 4493) were compared with patients without exact admission time and excluded from the analyzed patients (n = 1212). No differences in demographic characteristics or risk factor profiles were identified between the two groups, except for the NIHSS score and rtPA within three hours of stroke onset, as shown in <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0138046#pone.0138046.s002\" target=\"_blank\">S2 Table</a>. Patients with exact admission time had higher NIHSS scores at admission and were more likely to receive rtPA compared with those without admission time.</p>", "links"=>[], "tags"=>["Ischemic stroke", "Acute Ischemic Stroke", "CNSR", "pm", "China National Stroke Registry", "am", "China National Stroke Registry Background"], "article_id"=>1547577, "categories"=>["Uncategorised"], "users"=>["Guifen Wang", "Gaifen Liu", "Runhua Zhang", "Ruijun Ji", "Baoqin Gao", "Yilong Wang", "Yuesong Pan", "Zixiao Li", "Yongjun Wang"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0138046.g001", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Patient_flow_diagram_/1547577", "title"=>"Patient flow diagram.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-09-17 03:43:18"}

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Relative Metric

{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}
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