|
Medical management of stroke patient during hospital stay |
||||
| Before the introduction of pathway |
After the introduction of pathway |
p-value |
||
|
|
||||
| Investigations during the admission |
CT scan in 1st 48 hrs |
96% |
92% |
0.293 |
| Carotid duplex ultrasound |
26% |
28% |
0.817 |
|
| Echocardiogram |
42% |
26% |
0.047 |
|
| ESR or CRP in 1st 48 hrs |
57% |
61% |
0.143 |
|
| Fasting blood sugar and lipids |
32% |
44% |
0.143 |
|
| MRI |
10% |
5% |
0.238 |
|
|
|
||||
| Specific medical issues |
Aspirin given in first 48 hours to patients without contraindications |
26/55 (46%) |
40/66 (61%) |
0.117 |
| Paracetamol given to those with fever > 38°C in first 48 hours |
3/4 (75%) |
5/5 (100%) |
0.574 |
|
| Acute blood pressure management consistent with guideline |
63.6% |
71.1% |
0.328 |
|
| Prophylaxis for deep vein thrombosis (except aspirin) |
20.8% |
14.5% |
0.306 |
|
| Hypoglycemic agents given to those with blood sugar >15 mmol/l in first 48 hours |
1/2 (50%) |
2/2 (100%) |
0.312 |
|
|
|
||||
| Risk factor treatment at discharge |
Anti-hypertensive treatment if sBP>140 or dBP>90 at any time during admission |
44/50 (88%) |
51/58 (88%) |
0.242 |
| Warfarin if ECG shows atrial fibrillation |
6/18 (33%) |
4/10 (40%) |
0.264 |
|
| Statin if total cholesterol > 3.5 |
42/55 (76%) |
48/61 (79%) |
0.341 |
|
| Cessation programme for current smokers |
5/10 (50%) |
8/10 (80%) |
0.638 |
|
| Optimisation of glycemic control if diabetes present |
8/12 (67%) |
8/9 (100%) |
0.410 |
|
| US carotid arteries requested or performed if anterior circulation infarct |
19/60 (32%) |
24/59 (41%) |
0.610 |
|
Taylor et al. BMC Health Services Research 2006 6:16 doi:10.1186/1472-6963-6-16 |
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