| Methods |
Uncontrolled before‐and‐after study. Retrospective data collection. |
| Participants |
140 patients with ischaemic strokes ‐ CP group 67, 'before' group 73. |
| Interventions |
TREATMENT GROUP: Stroke clinical pathway care from Jan 1996 to May 1997 (16 months): daily written patient care plan to aid and improve documentation of acute stroke care, rehab, and discharge planning; used by doctors, nurses and therapists; a lay version of pathway provided for patient and carer. CONTROL GROUP: Undefined patient care from Jan‐Dec 1994 (12 months); CP introduced as a method to improve patient care. |
| Outcomes |
Mean LOS (days): CP (1993‐4)=8.9 vs Before (1995‐8)=6.3. Total CT: CP=63/67 vs Before=70/73 (NS). CT<24 hr: CP=60/67 vs Before=53/73 (p=0.002). ECG: CP=63/67 vs Before=68/73 (NS). CXR: CP=65/67 vs Before=70/73 (NS). Echo: CP=57/67 vs Before=46/63 (p=0.003). Carotid Duplex: CP=60/67 vs Before=53/73 (p=0.01). Cerebral angiogram/MRA: CP=35/67 vs Before=6/73 (p<0.0001). TEDS: CP=11/67 vs Before=4/73 (p=0.04). Subcutaneous heparin: CP=8/67 vs Before=2/73 (p=0.03). IV heparin: CP=22/67 vs Before=15/73 (NS). Acute treatment of hypertension after stroke: CP=0/67 vs Before=16/73 (p<0.0001). Use of drugs on discharge (excluding deaths): 1) warfarin: CP=14/65 vs Before=12/71 (NS); 2) aspirin: CP=32/65 vs Before=42/71 (NS); 3) ticlodipine: CP=15/65 vs Before=59/71 (NS). No significant change in cost over time. |
| Notes |
Acute stroke and rehabilitation. No data on patient characteristics. Unclear difference between CP and standard care. |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Allocation concealment? |
Unclear risk |
D ‐ Not used |
