Deans' stroke musings: Does implementation of a standardized pathway of stroke care affect functional outcome after stroke?

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, September 21, 2022

Does implementation of a standardized pathway of stroke care affect functional outcome after stroke?

The whole problem here is they are trying to standardize 'care', NOT recovery protocols. They don't have a fucking clue on how to solve stroke.

Does implementation of a standardized pathway of stroke care affect functional outcome after stroke?

Elin Bergh https://orcid.org/0000-0001-6947-9011 Elin.Josefina.Bergh@ahus.no, Torunn Askim, […], and Bente Thommessen https://orcid.org/0000-0002-8665-1108, +3 View all authors and affiliations

Express Articles

https://doi.org/10.1177/17474930221126592

Abstract

Background:

A stroke care pathway (SCP) was introduced in Norway in 2018. The goal of the pathway was to avoid delay in treatment and diagnostics of acute stroke and to secure treatment according to national guidelines. In this study, we aimed to evaluate how the implementation of the SCP affects outcome after stroke.

Methods:

We performed a register-based study using data from the Norwegian Stroke Register that covers 87% of acute stroke patients in Norway.

Patients included one year before and one year after the introduction of the care pathway were compared (2017 versus 2019). Change in functional outcome, the proportion of independent patients 90 days post-stroke, discharge destination, proportions admitted to stroke units and 90 days mortality were compared. Functional outcome was measured using modified Rankin Scale (mRS) and functional independence was defined as mRS 0-2.

Results:

In total 11 009 patients with 90 days follow-up data were analysed. Comparing the cohorts from 2017 and 2019 there was no change in demographics or stroke characteristics. No statistically significant differences in mRS, admission to thrombolysis time or 90 days mortality were found. However, the proportion of patients discharged directly home and treated in a stroke unit increased from 2017 to 2019.

Conclusion:

The implementation of a standardized pathway of stroke care in Norway, did not lead to improvement in functional outcome or a reduction in 90 days mortality. However, the proportion of patients discharged directly home increased, and more patients were treated in stroke units in 2019 compared to 2017.