Association Between Adherence to Quality Indicators and 7-Day In-Hospital Mortality After Acute Ischemic Stroke
| Autor: | Klaus Berger, Susanne Rode, Kirsten Haas, Peter Hermanek, Christine Matthis, Christoph Burmeister, Günter Seidel, Viktoria Rücker, Peter U. Heuschmann, Hans-Christian Koennecke, Björn Misselwitz, Alfred Janssen |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Quality management media_common.quotation_subject Neuroimaging Hospital mortality Speech Therapy Time-to-Treatment Young Adult Occupational Therapy Germany Atrial Fibrillation Medicine Humans Mass Screening Quality (business) Thrombolytic Therapy Hospital Mortality Stroke Routine care Acute ischemic stroke Early Ambulation Physical Therapy Modalities media_common Acute stroke Aged Ischemic Stroke Quality Indicators Health Care Quality of Health Care Advanced and Specialized Nursing Aged 80 and over In hospital mortality business.industry Process Assessment Health Care Stroke Rehabilitation Middle Aged medicine.disease Cerebral Angiography Emergency medicine Female Neurology (clinical) Cardiology and Cardiovascular Medicine business Deglutition Disorders Platelet Aggregation Inhibitors |
| Zdroj: | Stroke. 51(12) |
| ISSN: | 1524-4628 |
| Popis: | Background and Purpose: Quality indicators (QI) are an accepted tool to measure performance of hospitals in routine care. We investigated the association between quality of acute stroke care defined by overall adherence to evidence-based QI and early outcome in German acute care hospitals. Methods: Patients with ischemic stroke admitted to one of the hospitals cooperating within the ADSR (German Stroke Register Study Group) were analyzed. The ADSR is a voluntary network of 9 regional stroke registers monitoring quality of acute stroke care across 736 hospitals in Germany. Quality of stroke care was defined by adherence to 11 evidence-based indicators of early processes of stroke care. The correlation between overall adherence to QI with outcome was investigated by assessing the association between 7-day in-hospital mortality with the proportion of QI fulfilled from the total number of QI the individual patient was eligible for. Generalized linear mixed model analysis was performed adjusted for the variables age, sex, National Institutes of Health Stroke Scale and living will and as random effect for the variable hospital. Results: Between 2015 and 2016, 388 012 patients with ischemic stroke were reported (median age 76 years, 52.4% male). Adherence to distinct QI ranged between 41.0% (thrombolysis in eligible patients) and 95.2% (early physiotherapy). Seven-day in-hospital mortality was 3.4%. The overall proportion of QI fulfilled was median 90% (interquartile range, 75%–100%). In multivariable analysis, a linear association between overall adherence to QI and 7-day in-hospital-mortality was observed (odds ratio adherence P Conclusions: Higher quality of care measured by adherence to a set of evidence-based process QI for the early phase of stroke treatment was associated with lower in-hospital mortality. |
| Databáze: | OpenAIRE |
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