Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Journal：BMC Neurology

Publication type: Research

IF(IF): 2.6

PMID: PMID: 37542260 Link To Pubmed Full text Download

Stroke is a leading cause of death and disability globally, stroke rehabilitation improves functional recovery among stroke patients.Subarachnoid hemorrhage (SAH) is a serious and complex disease, the 30-day mortality rate is 18%~40%.The incidence rate ranges from 4 to 10 per 100 000 person years in most countries. In SAH care , early rehabilitation has been established as an integral part of treatment, resulting in reduced mortality, fewer complications and better functional outcomes .However, rehabilitation of patients with SAH is stable, as some patients take a longer time to get functional improvement, times required for getting “stable” conditions may be different in each SAH patient.In addition, there are significant differences in the implementation rates of stroke rehabilitation in different regions.Furthermore, the influencing factors of subarachnoid hemorrhage rehabilitation need to be further studied based on multicenter and large samples. In China, there are few reports showing national rehabilitation data. Therefore, it is necessary to provide data on the implementation rate and influencing factors of rehabilitation for hospitalized patients with subarachnoid hemorrhage nationwide. We used data from the China Stroke Center Allianc. The purpose of the study is to clarify the status of rehabilitation rate and evaluation of patients with subarachnoid hemorrhage , and to provide evidence for clinical rehabilitation care.

The implementation and analysis of the study is based on CSCA. The CSCA is a national, hospital-based, multicentre, voluntary, multifaceted intervention and continuous QI initiative. Patients were recruited consecutively in all 1476 hospitals from August 2015 to July 2017, who met the following criteria: (1) are aged 18 years or older; (2) have a primary diagnosis of acute ischemic stroke confirmed by brain CT or MRI; (3) are within 7 days of symptom onset; (4) are admitted either directly to wards or through the emergency department. Patients with TIA were excluded. The proportion of patients who received assessment of rehabilitation was described at the patient level. The adherent rate of rehabilitation assessment at the hospital level was defined as the total number of eligible patients receiving rehabilitation assessment divided by the total number of eligible patients of each hospital. Baseline patient-level characteristics were compared for patients with and without a rehabilitation assessment and hospital-level features were compared for hospitals above and below the median rate of assessment by using Pearson chi-square tests for categorical variables and Mann-Whitney U test for continuous variables. A multivariable logistic regression model with the generalized estimating equation method accounting for in-hospital clustering was performed to identify patient and hospital characteristics independently associated with rehabilitation assessment. All tests are two-tailed with p < 0.05 to be considered as the level of statistical significance. All analyses were performed by using SAS Version 9.3 software.