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

Journal：BMJ open

Publication type: Original Contributions

IF(IF): 3.006

PMID: 35680259 Link To Pubmed Full text Download

Previous studies have shown that hospital volume may be associated with outcomes in specific surgical procedures and medical conditions. Several studies have examined the association between hospital stroke volume and mortality for stroke patients. However, the results were controversial, with some found that stroke patients in high-volume hospitals had decreased case-fatality, but some not. What’s more, most of the studies evaluated the short-term mortality, and limited data exist to characterized the associations between hospital volume and long-term mortality and functional outcomes. In this study, our objective was to examine the association between hospital stroke volume and outcomes, including mortality and poor functional outcomes at 1 year after stroke onset.

Design A multicentre prospective cohort study. Setting Two hundred and seventeen secondary or tertiary public hospitals from China. Participants A total of 17 550 patients within 7 days of acute ischaemic stroke were included. Main outcome measures The outcomes included all-cause mortality, poor outcome, recurrent stroke, and combined vascular events at 3 months and 1 year. The patients were divided into four groups based on quartiles of the hospital volume. We compared the difference in the process of care across the groups and estimated the effects of hospital volume on mortality, poor outcome, recurrent stroke, and combined vascular events at 3 months and 1 year. Restricted cubic splines were used to illustrate the association between hospital volume and clinical outcomes.