Comparison Process of in-Patient Versus Out of Hospital Stroke Onset of Metricsina Community Primary Stroke Center | Chapter 10 | Medical Research and Its Applications Vol. 5

Objective: The present study examines in-hospital stroke onset metrics and outcomes, quality of care, and mortality compared with out-of-hospital stroke in a single community-based primary stroke center.

Background: In-hospital stroke vs OHS comparisons of demographic characteristics, hospital characteristics, immediate treatment with thrombolysis therapy, and mortality have been found to favor OHS cohorts in multiple studies.

Patients and Methods: We performed a retrospective analysis of all patients for whom an IHS stroke alert occurred during admission to our hospital between January 1, 2013, and December 31, 2019. Time-sensitive stroke process metric data were collected for each incident stroke alert. The primary focus of interest was the time-sensitive stroke quality metrics. The secondary focus pertained to thrombolysis treatment or complications, and mortality. Descriptive and univariable statistical analyses were applied. Kruskal-Wallis and c2 tests were used to compare median values and categorical data between prespecified groups. The statistical significance was set at p<.05.

Results: The out-of-hospital group reported a more favorable response to time-sensitive stroke process

metrics than the in-hospital group, as measured by median stroke team response time (15.0 vs 26.0 minutes; P≤.0001) and median head computed tomography scan completion time (12.0 vs 41.0 minutes; p<.0001). There was no difference in the stroke alert time between the 2 groups (14.0 vs 8.0 minutes; p .99). Longer hospital length of stay (4 vs 3 days; p.0001) and increased hospital mortality (19.3% vs 7.4%; p.001) were observed for the in-hospital group. The association between time-sensitive stroke process metrics and outcomes, such as hospital mortality and hospital length of stay, in the IHS cohort may be co-founded by higher baseline comorbidities, a higher risk of hospital complications, lower eligibility, and a higher number of contraindications for intravenous thrombolysis therapy and thrombectomy in the IHS cohort.

Conclusions: It is revealed that the out-of-hospital groups' time-sensitive stroke process metrics and stroke outcome measures outperformed the in-hospital groups'. Enhancing time-sensitive stroke process indicators could lead to better outcomes for the stroke cohort receiving care in hospitals.

 

Author(s)details:-

 

Felix E Chukwudelunzu
Department of Neurology, Mayo Clinic Health System, Eau Claire, Wisconsin, USA.

 

Bart Demaerschalk
Department of Neurology, Mayo Clinic College of Medicine and Sciences, Phoenix, Arizona, USA.

Leonardo, Fugoso
Department of Neurology, Mayo Clinic Health System, Eau Claire, Wisconsin, USA.

 

Emeka, Amadi
Department of Medicine, Section Hospital Medicine, Mayo Clinic Health System, Eau Claire, Wisconsin, USA.

 

Donn, Dexter
Department of Neurology, Mayo Clinic Health System, Eau Claire, Wisconsin, USA.

 

Angela, Gullicksrud
Department of Neurology, Mayo Clinic Health System, Eau Claire, Wisconsin, USA.

 

Clinton, Hagen
Program of Hypoplastic Left Heart Syndrome, Mayo Clinic Rochester, Rochester, Minnesota. USA.

 

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