Clinical Scorecard: Hospital Performance and Geographic Variations in Acute Stroke Reperfusion: A Multicenter Analysis from Sichuan Province, China

At a Glance

Key Highlights

• High and stable door-to-needle time (DNT) and IVT rates observed.
• Notable variation in puncture-to-recanalization time (PRT) compliance and EVT accessibility.
• Tertiary A-level hospitals and certified stroke centers showed higher performance in key indicators.
• Transient spike in EVT-related mortality in non-tertiary A-level and non-stroke center hospitals in 2023.
• Identified three hospital-level performance patterns indicating disparities in stroke care.

Guideline-Based Recommendations

Diagnosis

• Diagnosis of AIS based on clinical symptoms and neuroimaging findings.

Management

• IVT within 4.5 hours and EVT within 6 hours for eligible patients.

Monitoring & Follow-up

• Monitor door-to-needle time (DNT), door-to-puncture time (DPT), and puncture-to-recanalization time (PRT).

Risks

• Increased EVT-related mortality in non-tertiary A-level and non-stroke center hospitals.

Patient & Prescribing Data

Patients with acute ischemic stroke treated in Chengdu hospitals.

Timely reperfusion therapy is critical for improving outcomes.

Clinical Best Practices

• Implement hierarchical stroke center networks to improve access and quality of care.
• Enhance training and infrastructure in non-tertiary A-level hospitals.

Related Resources & Content

• Global Burden of Disease Study 2019
• AHA/ASA Guidelines for Stroke Management