Impact of Evidence‐Based Stroke Care on Patient Outcomes: A Multilevel Analysis of an International Study. Issue 13 (2nd July 2019)

• Record Type: Journal Article
• Authors: Muñoz Venturelli, Paula; Li, Xian; Middleton, Sandy; Watkins, Caroline; Lavados, Pablo M.; Olavarría, Verónica V.; Brunser, Alejandro; Pontes‐Neto, Octavio; Santos, Taiza E. G.; Arima, Hisatomi; Billot, Laurent; Hackett, Maree L.; Song, Lily; Robinson, Thompson; Anderson, Craig S.
• Other Names: Mead Gillian investigator.; De Silva H. Asita investigator.; Pandian Jeyaraj D. investigator.; Lin Ruey‐Tay investigator.; Lee Tsong‐Hai investigator.; Cui Liying investigator.; Peng Bin investigator.; Heritier Stephane investigator.; Lindley Richard investigator.; Jan Stephen investigator.; Boaden Elizabeth investigator.; Chen Christopher P. L. H. investigator.; Forster Anne investigator.; Billot Laurent investigator.; Woodward Mark investigator.; Rogers Kris investigator.; Scaria Anish investigator.; Lim Joyce Y. investigator.; Espinosa Natalie investigator.; McEvoy Lucy investigator.; Blackburn Lee investigator.; Richtering Sarah S. investigator.; You Shoujiang investigator.; Ladwig Simon investigator.; Merritt Gabrielle P. investigator.; Thomsen Bryce investigator.; Jenson Kerry investigator.; Gordon Penelope investigator.; Nguyen Dennis Ryan investigator.; Quan Wei Wei investigator.; Lo Tessa Pei‐Yi investigator.; Lim Jonathan investigator.; Goh Selena investigator.; Liu Leibo investigator.; Baig Mirza Ahmad investigator.; Singh Ravider investigator.; Donnelly Paul investigator.; Armenis Manuela investigator.; Zyl Marna Van investigator.; Monaghan Helen investigator.; Smith Phillipa investigator.; Glass Parisa investigator.; Zhou Fanli investigator.; Shen Yun investigator.; Lei Li investigator.; Li Di investigator.; Zhang Ting investigator.; Zhang Xiaoyan investigator.; Peng Yun investigator.; Feng Lingling investigator.; Ye Zhiping investigator.; Gregory Philip investigator.; Pandain Jeyaraj D. investigator.; Arora Deepti investigator.; Lavados Pablo M. investigator.; Gonzalez Francisca investigator.; Portales Bernardita investigator.; Pontes‐Neto Octavio investigator.; Santos‐Pontelli Taiza investigator.; Rimoli Brunna investigator.; Braga Monica investigator.; Vidal Carolina investigator.; Benadof Dafna investigator.; Rivas Rodrigo J. investigator.; Carvallo Laura investigator.; Carvallo Pamela investigator.; Miranda Rubia investigator.; Pileggi Brunna investigator.; de Silva H. Asita investigator.; Weerawardena Shalomi investigator.; Jeevarajah Thanushanthan investigator.; Dharmawardena Devaki investigator.; Ranasinghe Dumindi investigator.; Dharshana Matheesha investigator.; Nandadeva Nilesh investigator.; Nawarathna Savithri investigator.; Lin Ruey‐Tay investigator.; Lee Tsong‐Hai investigator.; Yin Jiu‐Haw investigator.; Yeh Shoou‐Jeng investigator.; Ma Ruei‐Jen investigator.; Watkins Caroline L. investigator.; Whiteley Gemma investigator.; Forshaw Denise investigator.; Lightbody Catherine Elizabeth investigator.; Cox Joanna investigator.; Fitzgerald Jane investigator.; Heney John F. investigator.; Byfield Helen investigator.; Finley Simone investigator.; Tyrer Hayley E. investigator.; Bruce Carole investigator.; Gibbon Alison investigator.; Jones Brett investigator.; Siracusa Emma investigator.; Gowda Koushik investigator.; Cowans Shahla investigator.; Forman Briana investigator.; Jacob Sherin investigator.; Caprecho Kristine investigator.; Khatri Roshan investigator.; Wan Po Yi investigator.; Lopez Maria investigator.; Vanika Sifiso investigator.; Bleeker Wilhelmina investigator.; Ireland Marinka investigator.; Jala Sheila investigator.; Day Susan investigator.; Ha Eric investigator.; Krause Martin investigator.; Passer Melissa investigator.; Giaccari Sarah investigator.; Burkolter Nadia investigator.; Braithwaite Michael investigator.; Tastula Kylie investigator.; Ghia Darshan investigator.; Musuka Tapuwa investigator.; Alvaro Anthony investigator.; Edmonds Gillian investigator.; O'Loughin Nicole investigator.; Phair Rebecca investigator.; Kaoutal Joanne investigator.; Blacker David J. investigator.; Saint Belinda L investigator.; Parrey Kim investigator.; Coad Michelle investigator.; Kinchington Matthew investigator.; Senanayake Nishantha investigator.; Alaban Johanna investigator.; Kuehne Irma investigator.; Santos‐Pontelli Taiza investigator.; Braga Monica investigator.; Rimoli Brunna investigator.; Camilo Millene investigator.; Libardi Milena investigator.; Martins Sheila investigator.; Carlos Batista investigator.; Martins Magda investigator.; Carbonera Leonardo investigator.; Almeida Andrea investigator.; Kelin Martin investigator.; Pauli Carla investigator.; Lunardi Mariana investigator.; Silveira Luciane investigator.; Chagas Olga investigator.; Souza Daily investigator.; Braga Gabriel investigator.; Ribeiro Priscila investigator.; Luvizutto Gustavo investigator.; Polin Marcia investigator.; Winckler Fernanda investigator.; Liu Jinfeng investigator.; Wang Zhenjiang investigator.; Wang Huibing investigator.; Lin Suying investigator.; Dong Jing investigator.; Zhou Junshan investigator.; Qin Suping investigator.; Zhan Hui investigator.; Xue Yongquan investigator.; Tian Dong investigator.; Yang Dan investigator.; Yin Yan investigator.; Li He investigator.; Geng Changming investigator.; Liu Jieyi investigator.; Jiang Xiaolin investigator.; Wu Yujun investigator.; Sun Wei investigator.; Yu Bingqi investigator.; Guan Yanmei investigator.; Wang Qin investigator.; Wei Bo investigator.; Wang Huirong investigator.; Wang Yan investigator.; Tai Liwen investigator.; Zhang Wenchao investigator.; Zhao Weili investigator.; Wang Xueying investigator.; Li Guoli investigator.; Ni Zhiming investigator.; Guo Fudong investigator.; Cen Lan investigator.; Lu Jun investigator.; Chen Zheng investigator.; Yin Guoming investigator.; Wang Yingchun investigator.; Zheng Jiping investigator.; Zhou Zhimin investigator.; Wang Hongquan investigator.; Zou Renlin investigator.; Xue Bin investigator.; Li Airu investigator.; Guo Jing investigator.; Guo Ying investigator.; Jiang Xingguo investigator.; Tan Xiuge investigator.; Zhang Chunpeng investigator.; Shao Bei investigator.; Niu Xiaoting investigator.; Liu Chunfeng investigator.; Chen Dongqin investigator.; Liang Ping investigator.; Zhang Xia investigator.; Zhang Chunqing investigator.; Gong Wenjie investigator.; Huang Zhichao investigator.; Liu Huihui investigator.; You Shoujiang investigator.; Huang Junying investigator.; Shi Rongfang investigator.; Wang Cuilan investigator.; Liu Ying investigator.; Wang Jinchao investigator.; Wu Guojun investigator.; Gao Zhihong investigator.; Lin Qunli investigator.; Xu Cong investigator.; Zheng Huile investigator.; Ye Xinghai investigator.; Jin Xiaoqiong investigator.; Liu Junyan investigator.; Cao Xiaoyun investigator.; Zhang Yan investigator.; Wang Jinyang investigator.; Xu Yuzhu investigator.; Li Yan investigator.; Ma Xin investigator.; Kong Qi investigator.; Hao Yanlei investigator.; Qiao Baojun investigator.; Yan Hui investigator.; Huang Zhiyong investigator.; Chang Baoqiang investigator.; Yan Jinjin investigator.; Liao Pinjun investigator.; Zhang Wei investigator.; Liu Ling investigator.; Zhu Tingting investigator.; Liu Xuehui investigator.; Li Yongping investigator.; Dong Ruifang investigator.; Chen Miao investigator.; Ge Xiaoli investigator.; Wang Hairong investigator.; Dai Lihua investigator.; Liu Jiafu investigator.; Wang Shixia investigator.; Du Jihui investigator.; Song Aixiu investigator.; Li Yunhai investigator.; Feng Jie investigator.; Yu Cheng investigator.; Feng Honglin investigator.; Sun Xiaojia investigator.; Sun Ruihong investigator.; Liu Weisong investigator.; Liu Jianfeng investigator.; Lu Xuesheng investigator.; Chen Enzhuo investigator.; Gao Wei investigator.; Liu Hui investigator.; Wang Heping investigator.; Wang Yanxia investigator.; Song Juan investigator.; Liu Dongqi investigator.; Du Wenhui investigator.; Li Guixia investigator.; Li Cuiling investigator.; Liang Yanling investigator.; Cai Xuekun investigator.; Zhang Jinli investigator.; Tao Xiaowei investigator.; An Pingshun investigator.; Tang Ranran investigator.; Qin Xu investigator.; Wang Yingling investigator.; Zhang Wenjun investigator.; Ma Rong investigator.; Huang Xiaoqiong investigator.; Liu Yonglin investigator.; Wang Yazhi investigator.; Fan Ping investigator.; Yang Hailan investigator.; Feng Lianyuan investigator.; Zhi Jianxia investigator.; Zhang Jiewen investigator.; Zhou Yao investigator.; Wu Danhong investigator.; He Haiyan investigator.; Chen Xiaohong investigator.; Hou Yongge investigator.; Su Xiaohui investigator.; Cui Liying investigator.; Peng Bin investigator.; Fan Siyuan investigator.; Suárez Luis investigator.; de Dios Polanco Juan investigator.; Sotomayor Patricio investigator.; Urzúa Ricardo investigator.; Urrutia Daniela investigator.; Conejan Nathalie investigator.; Escobar Arturo investigator.; Gonzalez Monica investigator.; Vargas Danisa investigator.; Constante Angel investigator.; Vásquez Erika investigator.; Godoy Elizabeth investigator.; Figueroa Christian investigator.; Martin Vanesa San investigator.; Vidal Nataly investigator.; Muñoz Madeleyn investigator.; Brunser Alejandro investigator.; Spencer María investigator.; Almeida Juan investigator.; Acosta Ignacio investigator.; Guerrero Rodrigo investigator.; Lozano Prudencio investigator.; Aguayo Camila investigator.; Pizarro Jimena investigator.; Soto Alvaro investigator.; Bonilla Flor investigator.; García Pía investigator.; Castillo Carolina Del investigator.; Grandjean Marcela investigator.; Von Johnn Alexis investigator.; Gutierrez Ignacio investigator.; Rivero Francisca investigator.; López Ignacio investigator.; Silva Federico investigator.; Pachón Marlen investigator.; Mendoza José investigator.; Pabón Alexander investigator.; Kate Mahesh investigator.; Akhtar Naushad investigator.; Narang Gibbsdeep S. investigator.; Deepak Ashish investigator.; Huded Vikram investigator.; De Sowza Romnesh investigator.; Sigamani Alben investigator.; Rajendran Karthikeyan investigator.; Vishwanath Anisha investigator.; K Anusha investigator.; Kumaravelu Somasundaram investigator.; Rahamath Syed investigator.; Kannneganti Sandeep investigator.; Khurana Dheeraj investigator.; Katoch Cheena investigator.; Kaur Taranpreet investigator.; Karadan Ummer investigator.; Kuriakose Anu investigator.; John Jaison investigator.; Basheer Mumthaz investigator.; Gunasekara Harsha Hemal investigator.; De Silva Gamlath Chandima Udeni investigator.; Ubeywickrama Peetagam Harshi Lakmali investigator.; Silva Kavisha Chathumali investigator.; De Silva Eshani Anuradha investigator.; Ranawaka Udaya investigator.; Mettananda Chamila investigator.; Nanayakkara Yamuna investigator.; Mendis Tharini investigator.; Fernando Gayathri investigator.; Imthikab Ahamed investigator.; Pieris Kandula investigator.; Gunatilake Saman B. investigator.; Madanayake Pamuditha M. W. investigator.; Paranavitane Shiran A. investigator.; Senanayake Bimsara investigator.; Vishwanathan Vaidhehi investigator.; Sivapalan Maathury investigator.; Murage Ruwangi U. investigator.; Chandradeva Uthpala investigator.; Lin Ruey‐Tay investigator.; Liu Yao‐Hua investigator.; Lin Chih‐Lung investigator.; Lin Hsiu‐Fen investigator.; Liu Kuan‐Ting investigator.; Chen Chien‐Fu investigator.; Wu Meng‐Ni investigator.; Tsai Su‐Hua investigator.; Chen Chi‐Ching investigator.; Chen Lan‐Yi investigator.; Lee Tsong‐Hai investigator.; Chang Chien‐Hung investigator.; Chang Yeu‐Jhy investigator.; Huang Kuo‐Lun investigator.; Chang Ting‐Yu investigator.; Liu Chi‐Hung investigator.; Seak Chen‐June investigator.; Lin Yu‐Li investigator.; Luo Jia‐Yi investigator.; Yang Hsiao‐Ying investigator.; Wang Ching‐Yi investigator.; Chan Lung investigator.; Hu Chaur‐Jong investigator.; Chi Nai‐Fang investigator.; Wu Dean investigator.; Huang Yao‐Hsien investigator.; Kuan Yi‐Chun investigator.; Hong Chien‐Tai investigator.; Chen Yi‐Chun investigator.; Sun Yu investigator.; Lin Cheng‐Huai investigator.; Lu Chien‐Jung investigator.; Chu Hai‐Jui investigator.; Lo Yi‐Chia investigator.; Chang Wen‐Hui investigator.; Lin Wan‐Jung investigator.; Su Hui‐Chen investigator.; Lin Tien‐Yu investigator.; Cho Chi‐Hsuan investigator.; Lu Shu‐Lan investigator.; Hsueh Ya‐Fang investigator.; Lai Ching‐Yi investigator.; Jarrett David investigator.; James Claire investigator.; Valentine Stacey investigator.; Whistler Clare investigator.; Butler Rebecca investigator.; Browning Simone investigator.; Watchurst Caroline investigator.; Erande Renuka investigator.; Elliott Emma investigator.; Patel Krishna investigator.; Brezitski Maria investigator.; Hogan Caroline investigator.; Banaras Asra investigator.; Crook Lucinda investigator.; Ahmed Rashidat investigator.; Potter Lindsay investigator.; Laird Rosie investigator.; Clarke Natasha investigator.; Loosemore Alison investigator.; Godber J. investigator.; Gawned Sara investigator.; Hamilton K. A. investigator.; Jones Rachael investigator.; Guyler Paul investigator.; Tysoe Sharon investigator.; Prabakaran Raji investigator.; Shah Sweni investigator.; Calver Joanne investigator.; Sztriha Laszlo K. investigator.; Fitzpatrick Maria investigator.; Drysdale Stephanie investigator.; Aeron‐Thomas John investigator.; McKenzie Emma investigator.; Chitando Belinda investigator.; Willcoxson Paul investigator.; Iveson Elizabeth investigator.; Wanklyn Peter investigator.; Dyer Natasha investigator.; Keeling Michael investigator.; Rodriguez Romina investigator.; Elliott Kerry investigator.; Porteous Mia investigator.; O'Neill Mark investigator.; Orme Sheridan investigator.; Richardson Carla investigator.; Tomlinson Janet investigator.; Hawkins Suzanne investigator.; Bester Delia investigator.; Jeffs Carol investigator.; Howard Joanne investigator.; Brown Pauline investigator.; Ward Deborah investigator.; Turfrey Jennifer investigator.; Raybould Leanne investigator.; Bates Allison investigator.; O'Connell Sue investigator.; O'Connor Margaret investigator.; Williams Samantha investigator.; Emsley Hedley C. A. investigator.; McLoughlin Alison investigator.; Raj Sonia investigator.; Gregary Bindu investigator.; Doyle Donna investigator.; Courtauld G. M. investigator.; Schofield C. investigator.; Lucas L. investigator.; Lydon A. investigator.; James A. investigator.; Saastamoinen Kari investigator.; Howaniec Laura investigator.; Daboo Premchand investigator.; Ali Ali N. investigator.; Richards Emma investigator.; Howe Joanne investigator.; Kamara Christine investigator.; Stocks Kathy investigator.; Lindert Ralf investigator.; Day Diana J. investigator.; Finlay Sarah investigator.; McGee Joanne investigator.; Mitchell Jennifer investigator.; Amis Elaine investigator.; Macey Rosemary investigator.; Tauro Suzanne investigator.; Henry Lauren investigator.; Cuddy Sarah investigator.; Steele Andrew investigator.; Mullen Kerry investigator.; Kirker Sarah investigator.; Bhattad Murudappa investigator.; Carpenter Michael investigator.; Datta Prabal investigator.; Needle Ann investigator.; Jackson Linda investigator.; Ball Julie investigator.; Beckitt Rosie investigator.; Chivers Nicola investigator.; Bowring Angela investigator.; Eddy Sara investigator.; Thorpe Kevin investigator.; Keenan Samantha investigator.; Griffin Alison investigator.; Maguire Stuart investigator.; Patterson Chris investigator.; Ramadan Hawraman investigator.; Bellfield Ruth investigator.; Hooley Michaela investigator.; Stewart Kelvin investigator.; Williams Lucy investigator.; Gurney Cara investigator.; Oliver Deborah investigator.; Gardiner Maria investigator.; Grayland Sarah investigator.; Bhandari Mohit investigator.; Collas David M. investigator.; Adesina Tolu investigator.; Sundayi Saul investigator.; Harvey Ruth investigator.; Pope Emma investigator.; Lam Audrey investigator.; Walker Elaine investigator.; Merrill Colin investigator.; Banerjee Soma investigator.; Harvey Kirsten Hannah investigator.; Mashate Sheila investigator.; Wilding Peter investigator.; Johnson Linda investigator.; Namushi Robert investigator.; Jacob Patricia investigator.; Andole Sreeman investigator.; Dunne Karen investigator.; Gadapa Naveen investigator.; King Sam investigator.; Siliuzaite Sonata investigator.; Dealing Sharon investigator.; Attwood Karen investigator.; Woods Annette investigator.; Sandhu Banher investigator.; Mamun Maam investigator.; Mahmood Afzal investigator.; Jones June investigator.; Ojo Abimbola investigator.; Carter‐Evans Denise investigator.; Liverpool Royal investigator.; Manoj Aravind investigator.; Fletcher Glyn investigator.; Lopez Paula investigator.; Greig Jill investigator.; Robinson Matthew investigator.; Jones Sarah investigator.; Jones Lorinda investigator.; West Claire investigator.; Tench Helen investigator.; Gascoyne Rachel investigator.; Whileman Amanda investigator.; Hall Emily investigator.; Wright Stephanie investigator.; Toms Julie investigator.; Tomlinson Janet investigator.; Phiri Duke investigator.; Sethuraman Sakthivel investigator.; Mohammed Niaz investigator.; Justin Frances investigator.; Tate Margaret Louise investigator.; Chauhan Meena investigator.; Haider Syed I. investigator.; Nallasivan Arumugam investigator.; Webster Tim investigator.; Leason Sandra investigator.; Seagrave Samantha investigator.; Hospital Peterborough City investigator.; Owksu‐Agyei Peter investigator.; Temple Natalie investigator.; Butterworth‐Cowin Nicola investigator.; Magezi Frederick investigator.; Infirmary Leicester Royal investigator.; Khan Shagufta investigator.; Stephens Claire investigator.; Mistri Amit investigator.; Murphy Aidan investigator.; Lam Manda investigator.; Underwood Paul investigator.; Thompson Catherine investigator.; Buckley Clare investigator.; Wood Diane investigator.; Board Sarah investigator.; Howard Linda investigator.; Ahmed Ashraf investigator.; Oates Bethany investigator.; Leonard Sara investigator.; Hospital Royal Bournemouth investigator.; Bournemouth Royal investigator.; Thavanesan Kamy investigator.; Dharmasiri Michelle investigator.; Logianathan Sathyabama investigator.; Ovington Catherine investigator.; Hann Gail investigator.; Cox Chantel investigator.; Hospital Craigavon Area investigator.; Health Southern investigator.; Trust Social Care investigator.; Douglas Catherine investigator.; Goggin Michael investigator.; Fearon Patricia investigator.; Gilpin Sara investigator.; O'Hagan Margaret investigator.; Hospital Pilgrim investigator.; Hardwick Anne investigator.; Netherton Kimberley investigator.; Quinn Judith investigator.; Bozkaplan Tulu investigator.; Jose Josin investigator.;
• Is Part Of: Journal of the American Heart Association. Volume 8:Issue 13(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-07-02
• Subjects: acute stroke care -- multilevel analysis -- outcome -- quality; Heart -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cerebrovascular disease -- Periodicals; Cardiology -- Periodicals; 616.1
• DOI: 10.1161/JAHA.119.012640
• Languages: English
• ISSNs: 2047-9980

Abstract

Abstract : Background: The uptake of proven stroke treatments varies widely. We aimed to determine the association of evidence‐based processes of care for acute ischemic stroke (AIS) and clinical outcome of patients who participated in the HEADPOST (Head Positioning in Acute Stroke Trial), a multicenter cluster crossover trial of lying flat versus sitting up, head positioning in acute stroke. Methods and Results: Use of 8 AIS processes of care were considered: reperfusion therapy in eligible patients; acute stroke unit care; antihypertensive, antiplatelet, statin, and anticoagulation for atrial fibrillation; dysphagia assessment; and physiotherapist review. Hierarchical, mixed, logistic regression models were performed to determine associations with good outcome (modified Rankin Scale scores 0–2) at 90 days, adjusted for patient and hospital variables. Among 9485 patients with AIS, implementation of all processes of care in eligible patients, or "defect‐free" care, was associated with improved outcome (odds ratio, 1.40; 95% CI, 1.18–1.65) and better survival (odds ratio, 2.23; 95% CI, 1.62–3.09). Defect‐free stroke care was also significantly associated with excellent outcome (modified Rankin Scale score 0–1) (odds ratio, 1.22; 95% CI, 1.04–1.43). No hospital characteristic was independently predictive of outcome. Only 1445 (15%) of eligible patients with AIS received all processes of care, with significant regional variations in overall and individual rates. Conclusions: Use of evidence‐based care is associated with improved clinical outcome in AIS. Strategies are required to address regional variation in the use of proven AIS treatments. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique Identifier: NCT02162017.