Time-Sensitive Quality Metrics of Acute Stroke Care: A Comprehensive Stroke Center Experience.

Abstract

The stroke center approach provides an efective solution for acute stroke management. Our study aims to systematically analyze our stroke center records to identify factors that afect acute stroke time-sensitive quality metrics. Data were prospectively collected from 524 acute stroke patients at the Comprehensive Stroke Center of Atatürk UniversityMedical Faculty Hospital between January 1, 2021, and September 30, 2021. Data collected included sociodemographic, clinical, admission type, initial National Institutes of Health Stroke Scale (NIHSS), treatment modality, and time-sensitive metrics and were statistically analyzed based on stroke quality metrics. Patients with mild NIHSS scores (0-7) had longer onset-to-door (OTD) time, door-to-computed tomography (CT)/neurologist, and hospitalization times (P < .001). The OTD, door-to-CT/neurologist, and hospitalization times varied depending on the treatment methods used (P < .005). The OTD time was influenced by the patient's level of education (P=.004), admission type (P < .001), and geographical location (P=.002). A moderate negative correlation was found between patients' OTD time and baseline NIHSS (r=-0.270; P < 0.001). The results emphasize the significance of several factors, such as admission type, geographical location, and treatment methods, in shaping the time-sensitive quality metrics of stroke care. Additionally, the initial NIHSS score of patients plays a crucial role in both prehospital and in-hospital aspects of acute stroke management.