Table 1.
Number (percentage) of the responding hospitals fulfilling the recommended items of comprehensive stroke care capabilities
| Components | Items | 2010 | 2014 | 2018 | |||||||||
| All participating hsps (n=749) |
Consecutively participating hsps (n=323) |
Other hsps (n=426) |
P value | All participating hsps (n=532) |
Consecutively participating hsps (n=323) |
Other hsps (n=209) |
P value | All participating hsps (n=786) |
Consecutively participating hsps (n=323) |
Other hsps (n=464) |
P value | ||
| Personnel | Neurologists | 358 (47.8) | 176 (54.5) | 182 (42.7) | 0.001 | 283 (53.2) | 177 (54.8) | 106 (50.7) | 0.357 | 452 (57.5) | 210 (65.0) | 242 (52.2) | <0.001 |
| Neurosurgeons | 694 (92.7) | 314 (97.2) | 380 (89.2) | <0.001 | 515 (96.8) | 317 (98.1) | 198 (94.7) | 0.03 | 754 (95.9) | 317 (98.1) | 437 (94.2) | 0.006 | |
| Endovascular physicians | 272 (36.3) | 146 (45.2) | 126 (29.6) | <0.001 | 280 (52.6) | 196 (60.7) | 84 (40.2) | <0.001 | 428 (54.4) | 211 (65.3) | 217 (46.8) | <0.001 | |
| Emergency medicine | 162 (21.6) | 96 (29.7) | 66 (15.5) | <0.001 | 207 (38.9) | 146 (45.2) | 61 (29.2) | <0.001 | 427 (54.3) | 205 (63.5) | 222 (63.5) | <0.001 | |
| Physical medicine and rehabilitation | 113 (15.1) | 61 (18.9) | 52 (12.2) | 0.011 | 143 (26.9) | 95 (29.4) | 48 (23.0) | 0.102 | 313 (39.8) | 137 (42.4) | 176 (37.9) | 0.206 | |
| Rehabilitation therapy | 742 (99.1) | 321 (99.4) | 421 (98.8) | 0.435 | 529 (99.4) | 321 (99.4) | 208 (99.5) | 0.832 | 779 (99.1) | 321 (99.4) | 458 (98.7) | 0.354 | |
| Stroke rehabilitation nurses | 102 (13.6) | 48 (14.9) | 54 (12.7) | 0.388 | 157 (29.5) | 116 (35.9) | 41 (19.6) | <0.001 | 285 (36.2) | 146 (45.2) | 139 (30.0) | <0.001 | |
| Diagnostic | CT | 742 (99.1) | 322 (99.7) | 420 (98.6) | 0.122 | 527 (99.1) | 322 (99.7) | 205 (98.1) | 0.061 | 763 (97.1) | 322 (99.7) | 441 (85.0) | <0.001 |
| MRI with diffusion | 647 (86.4) | 291 (90.1) | 356 (83.6) | 0.01 | 504 (94.7) | 311 (96.3) | 193 (92.3) | 0.047 | 732 (93.1) | 314 (97.2) | 418 (90.1) | <0.001 | |
| Digital cerebral angiography | 602 (80.3) | 288 (89.2) | 314 (73.7) | <0.001 | 476 (89.4) | 305 (94.4) | 171 (81.8) | <0.001 | 638 (81.2) | 299 (92.6) | 399 (73.1) | <0.001 | |
| CT angiography | 627 (83.7) | 289 (89.5) | 338 (79.3) | <0.001 | 492 (92.5) | 305 (94.4) | 187 (89.5) | 0.034 | 701 (89.2) | 309 (95.7) | 392 (84.5) | <0.001 | |
| Carotid duplex ultrasound | 257 (34.3) | 126 (39.0) | 131 (30.8) | 0.018 | 219 (41.2) | 153 (47.4) | 66 (31.6) | <0.001 | 343 (43.6) | 169 (52.3) | 174 (37.5) | <0.001 | |
| TCD | 121 (16.2) | 70 (21.7) | 51 (12.0) | <0.001 | 123 (23.1) | 87 (26.9) | 36 (17.2) | <0.010 | 162 (20.6) | 95 (29.4) | 67 (14.4) | <0.001 | |
| Specific expertise | Carotid endarterectomy | 603 (80.5) | 292 (90.4) | 311 (73.0) | <0.001 | 458 (86.1) | 288 (89.2) | 170 (81.3) | 0.011 | 613 (78.0) | 284 (87.9) | 329 (70.9) | <0.001 |
| Clipping of intracranial aneurysm | 685 (91.5) | 314 (97.2) | 371 (87.1) | <0.001 | 504 (94.7) | 315 (97.5) | 189 (90.4) | <0.001 | 706 (89.8) | 314 (97.2) | 392 (84.5) | <0.001 | |
| Haematoma removal/draining | 689 (92.0) | 315 (97.5) | 374 (87.8) | <0.001 | 505 (95.0) | 315 (97.5) | 190 (90.9) | <0.001 | 718 (91.3) | 314 (97.2) | 404 (87.1) | <0.001 | |
| Coiling of intracranial aneurysm | 360 (48.1) | 192 (59.4) | 168 (39.4) | <0.001 | 332 (62.4) | 223 (69.0) | 109 (52.2) | <0.001 | 448 (57.0) | 223 (69.0) | 225 (48.5) | <0.001 | |
| Intra-arterial reperfusion therapy | 498 (66.5) | 245 (75.9) | 253 (59.4) | <0.001 | 398 (74.8) | 261 (80.8) | 137 (65.6) | <0.001 | 510 (64.9) | 247 (76.5) | 263 (56.7) | <0.001 | |
| Infrastructure | Stroke unit | 132 (17.6) | 74 (22.9) | 58 (13.6) | <0.001 | 202 (38.0) | 136 (42.1) | 66 (31.6) | 0.015 | 342 (43.5) | 171 (52.9) | 171 (36.9) | <0.001 |
| Intensive care unit | 445 (59.4) | 214 (66.3) | 231 (54.2) | <0.001 | 362 (68.0) | 224 (69.4) | 138 (66.0) | 0.422 | 467 (59.4) | 220 (68.1) | 247 (53.2) | <0.001 | |
| Operating room staffed 24/7 | 451 (60.2) | 230 (71.2) | 221 (51.9) | <0.001 | 339 (63.7) | 239 (74.0) | 100 (47.9) | <0.001 | 487 (62.0) | 243 (75.2) | 244 (52.6) | <0.001 | |
| Interventional services coverage 24/7 | 279 (37.3) | 147 (45.5) | 132 (31.0) | <0.001 | 317 (59.6) | 218 (67.5) | 99 (47.4) | <0.001 | 452 (57.5) | 219 (67.8) | 233 (50.2) | <0.001 | |
| Stroke registry | 235 (31.4) | 133 (41.2) | 102 (23.9) | <0.001 | 260 (48.9) | 172 (53.3) | 88 (42.1) | 0.012 | 349 (44.4) | 164 (50.8) | 185 (39.9) | 0.003 | |
| Education | Community education | 369 (49.3) | 188 (58.2) | 181 (42.5) | <0.001 | 144 (27.1) | 91 (28.2) | 53 (25.4) | 0.476 | 204 (26.0) | 98 (30.3) | 106 (22.8) | 0.018 |
| Professional education | 436 (58.2) | 207 (64.1) | 229 (53.8) | 0.005 | 326 (61.3) | 208 (64.4) | 118 (56.5) | 0.066 | 429 (54.6) | 184 (57.0) | 245 (52.8) | 0.249 | |
| Total CSC score | |||||||||||||
| Median (IQR) | 14 (11–18) |
16 (13–19) |
13 (10–17) |
<0.001 | 17 (13–19) |
18 (14–20) |
15 (12–18) |
<0.001 | 17 (12–20) |
19 (15–21) |
15 (10–19) |
<0.001 | |
CSC, comprehensive stroke centre; hsps, hospitals; TCD, transcranial Doppler.