Purpose: Translating research evidence into clinical practice often uses key performance indicators to monitor quality of care. We conducted a systematic review to identify the stroke key performance indicators used in large registries, and to estimate their association with patient outcomes.
Method: We sought publications of recent (January 2000-May 2017) national or regional stroke registers reporting the association of key performance indicators with patient outcome (adjusting for age and stroke severity). We searched Ovid Medline, EMBASE and PubMed and screened references from bibliographies. We used an inverse variance random effects meta-analysis to estimate associations (odds ratio; 95% confidence interval) with death or poor outcome (death or disability) at the end of follow-up.
Findings: We identified 30 eligible studies (324,409 patients). The commonest key performance indicators were swallowing/nutritional assessment, stroke unit admission, antiplatelet use for ischaemic stroke, brain imaging and anticoagulant use for ischaemic stroke with atrial fibrillation, lipid management, deep vein thrombosis prophylaxis and early physiotherapy/mobilisation. Lower case fatality was associated with stroke unit admission (odds ratio 0.79; 0.72-0.87), swallow/nutritional assessment (odds ratio 0.78; 0.66-0.92) and antiplatelet use for ischaemic stroke (odds ratio 0.61; 0.50-0.74) or anticoagulant use for ischaemic stroke with atrial fibrillation (odds ratio 0.51; 0.43-0.64), lipid management (odds ratio 0.52; 0.38-0.71) and early physiotherapy or mobilisation (odds ratio 0.78; 0.67-0.91). Reduced poor outcome was associated with adherence to swallowing/nutritional assessment (odds ratio 0.58; 0.43-0.78) and stroke unit admission (odds ratio 0.83; 0.77-0.89). Adherence with several key performance indicators appeared to have an additive benefit.
Discussion: Adherence with common key performance indicators was consistently associated with a lower risk of death or disability after stroke.
Conclusion: Policy makers and health care professionals should implement and monitor those key performance indicators supported by good evidence.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6453192 | PMC |
| http://dx.doi.org/10.1177/2396987317735426 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Association of fully branded, standardized packaging and limited flavor and brand descriptors of e-liquids with interest in trying products among youths in Great Britain.
Addiction
January 2025
Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Background And Aims: Many vaping products feature bright colors and novel brand names and flavor descriptors, which may appeal to youth. We measured the strength of the associations between e-liquid packaging design (branded, white standardized or white standardized limiting brand and flavor descriptors) and perceived peer interest in trying the e-liquids among youth.
Design: A between-subjects online experiment.
Impact of body mass index on in-hospital outcomes in patients receiving leadless pacemakers: A five-category analysis.
Heart Rhythm O2
December 2024
Department of Internal Medicine, Burnett School of Medicine at Texas Christian University (TCU) and Consultants in Cardiovascular Medicine and Science, Fort Worth, Texas.
Background: The adoption of leadless pacemakers (LPMs) is increasing, yet the impact of body mass index (BMI) on procedural outcomes remains underexplored.
Objective: The purpose of this study was to explore the impact of BMI on in-hospital outcomes for patients receiving LPM implantation.
Methods: Data from the National Inpatient Sample from 2018-2021 were analyzed for patients older than 18 years who underwent LPM implantation, with specific inclusion and exclusion criteria applied.
A negative relationship between first-pass pulmonary vein isolation and body mass index in ablation index-guided pulmonary vein isolation.
Heart Rhythm O2
December 2024
Department of Cardiology and Nephrology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Background: We previously reported the relationship between first-pass pulmonary vein isolation (FPI) and pulmonary vein isolation (PVI) durability in ablation index-guided atrial fibrillation ablation. Obesity is a worsening factor for atrial tachyarrhythmia (AT) recurrence. However, the impact of obesity on FPI has been scarcely reported.
View Article and Find Full Text PDFRisk of stroke with reduced dose direct oral anticoagulants vs standard dose anticoagulation after cardioversion of atrial fibrillation: A systematic review and meta-analysis.
Heart Rhythm O2
December 2024
Cardiology Department, Health Sciences North Research Institute, Northern Ontario School of Medicine University, Sudbury, Ontario, Canada.
Background: There is consensus on the safety of standard dose direct oral anticoagulants (DOACs) for stroke prevention in patients undergoing cardioversion of atrial fibrillation (AF), but outcomes of reduced dose DOACs in this setting remain unclear.
Objective: This systematic review and meta-analysis aimed to compare the rate of cardioversion-associated thromboembolic events between patients taking reduced dose DOACs and those receiving standard dose anticoagulation.
Methods: A systematic search was conducted for studies published between January 1, 2009, and February 16, 2024 in PubMed, Embase, and Cochrane Central Register of Controlled Trials.
Evaluating the role of serum cystatin C as a circulating biomarker of diabetic retinopathy from a rural Indian population.
Taiwan J Ophthalmol
November 2024
Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Tamil Nadu, India.
Purpose: This study aimed to evaluate serum cystatin C as a potential biomarker for diabetic retinopathy (DR) in a rural Indian population, addressing the urgent need for effective screening tools amidst rising diabetes prevalence.
Materials And Methods: A cross-sectional study recruited 112 patients with diabetes mellitus from Sambalpur, Odisha, India, categorized into groups with and without DR. Serum cystatin C levels were measured alongside clinical and demographic parameters, using established diagnostic methods.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!