| アブストラクト | BACKGROUND: Although the Brain Attack Coalition recommended establishing centers of comprehensive care for stroke and cerebrovascular disease patients, a scoring system for such centers was lacking. We created and validated a comprehensive stroke center (CSC) score, adapted to Japanese circumstances. METHODS: Of the selected 1369 certified training institutions in Japan, 749 completed an acute stroke care capabilities survey. Hospital performance was determined using a 25-item score, evaluating 5 subcategories: personnel, diagnostic techniques, specific expertise, infrastructure, and education. Consistency and validity were examined using correlation coefficients and factorial analysis. RESULTS: The CSC score (median, 14; interquartile range, 11-18) varied according to hospital volume. The five subcategories showed moderate consistency (Cronbach's alpha = 0.765). A strong correlation existed between types of available personnel and specific expertise. Using the 2011 Japanese Diagnosis Procedure Combination database for patients hospitalized with stroke, four constructs were identified by factorial analysis (neurovascular surgery and intervention, vascular neurology, diagnostic neuroradiology, and neurocritical care and rehabilitation) that affected in-hospital mortality from ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. The total CSC score was related to in-hospital mortality from ischemic stroke (odds ratio [OR], 0.973; 95% confidence interval [CI], 0.958-0.989), intracerebral hemorrhage (OR, 0.970; 95% CI, 0.950-0.990), and subarachnoid hemorrhage (OR, 0.951; 95% CI, 0.925-0.977), with varying contributions from the four constructs. CONCLUSIONS: The CSC score is a valid measure for assessing CSC capabilities, based on the availability of neurovascular surgery and intervention, vascular neurology, diagnostic neuroradiology, and critical care and rehabilitation services. |
|---|
| ジャーナル名 | BMC neurology |
|---|
| Pubmed追加日 | 2017/3/1 |
|---|
| 投稿者 | Kada, Akiko; Nishimura, Kunihiro; Nakagawara, Jyoji; Ogasawara, Kuniaki; Ono, Junichi; Shiokawa, Yoshiaki; Aruga, Toru; Miyachi, Shigeru; Nagata, Izumi; Toyoda, Kazunori; Matsuda, Shinya; Suzuki, Akifumi; Kataoka, Hiroharu; Nakamura, Fumiaki; Kamitani, Satoru; Iihara, Koji |
|---|
| 組織名 | Department of Clinical Trials and Research, Clinical Research Center, National;Hospital Organization Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya,;Aichi, 460-0001, Japan. akiko.kada@nnh.go.jp.;Center for Cardiovascular Disease Information, National Cerebral and;Cardiovascular Center, Suita, Japan.;Integrative Stroke Imaging Center, National Cerebral and Cardiovascular Center,;Suita, Japan.;Department of Neurosurgery, Iwate Medical University, Morioka, Japan.;Chiba Cardiovascular Center, Ichihara, Japan.;Department of Neurosurgery, Kyorin University, Mitaka, Japan.;Showa University, Tokyo, Japan.;Department of Neurosurgery, Osaka Medical College, Takatsuki, Japan.;Kokura Memorial Hospital, Fukuoka, Japan.;Departments of Cerebrovascular Medicine, National Cerebral and Cardiovascular;Center, Suita, Japan.;Department of Preventive Medicine and Community Health, University of;Occupational and Environmental Health, Kita-Kyushu, Japan.;Akita Prefectural Hospital Organization Research Institute for Brain and Blood;Vessels, Akita, Japan.;Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita,;Japan.;Department of Public Health, Graduate School of Medicine, The University of;Tokyo, Tokyo, Japan.;Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu;University, Fukuoka, Japan. |
|---|
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/28241749/ |
|---|
