To assess real-world performance of reperfusion care in acute ischemic stroke (AIS) across different hospitals in Sichuan Province.
Approach:
Study Design: Retrospective multicenter study across 33 hospitals in Chengdu from 2021 to 2024.
Indicators Assessed: Key process and outcome indicators included door-to-needle time (DNT), door-to-puncture time (DPT), puncture-to-recanalization time (PRT), intravenous thrombolysis (IVT) within 4.5 hours, endovascular treatment (EVT) within 6 hours, and in-hospital mortality a…
Data Analysis: K-means clustering was used to explore hospital-level performance patterns based on reperfusion indicators.
Key Findings:
Door-to-needle time (DNT) and intravenous thrombolysis (IVT) rates were relatively high and stable.
Notable variation in puncture-to-recanalization time (PRT) compliance and endovascular treatment (EVT) accessibility was observed.
Tertiary A-level hospitals, urban hospitals, and certified stroke centers showed higher performance in several indicators.
A transient spike in EVT-related mortality was noted in non-tertiary A-level and non-stroke center hospitals in 2023.
Three distinct hospital-level performance patterns were identified, indicating disparities in capacity, access, and EVT-related outcomes.
Interpretation:
Institutional and regional inequities in acute ischemic stroke (AIS) reperfusion care were highlighted, with stroke center status linked to better performance metrics.
Limitations:
Residual confounding cannot be excluded.
Conclusion:
Strategic investments in infrastructure, workforce training, and networked stroke systems are needed to promote equitable, high-quality stroke care in western China.
