A prospective, multicenter and cluster randomised controlled trial will be conducted, using hospital as randomisation unit. Hospitals in Zhejiang Province, China, will be randomised into two arms (1:1): an intervention arm and a control arm. Hospitals in the intervention arm will receive a multilevel system intervention based on information platform, whereas hospitals in the control arm will receive no intervention. The randomisation will be conducted after baseline data collection. The following baseline data will be used for randomisation match: hospital classification, beds in stroke centre, and the number of acute ischemic stroke (AIS) patients within 7 days of stroke onset. Hospitals with \<250 AIS cases per year will be excluded from the study. The primary outcome will be difference between intervention arm and control arm in the one-year stroke recurrence rate on the follow-up stage (post-intervention).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
60
1. Standardized templates of medical record 2. Continuous medical quality control and feedback system: the hospital included in the study upload the medical records of all AIS patients by medical records scanning system. Quality control platform of Cerebral apoplexy in Zhejiang province extracts and analyze the data through the computer and calculates the percentage of stroke of undetermined cause. 3. Team collaboration based on video conferencing: hospitals will receive corresponding suggestions for their improvement from experts online. 4. Enhanced feedback incentives
Min Lou
Hangzhou, Zhejiang, China
Incidence rate of new ischemic stroke events
To evaluate the efficacy of intervention in reducing the risk of new ischemic stroke events at 1 year after initial symptom onset.
Time frame: 1 year
Incidence rate of new ischemic stroke events
Incidence rate of new ischemic stroke events at 3, 5 years after initial symptom onset.
Time frame: 3, 5 years
Incidence rate of new clinical vascular events (ischemic stroke, hemorrhagic stroke, myocardial infarction)
incidence rate of new clinical vascular events (ischemic stroke, hemorrhagic stroke, myocardial infarction) at 1, 3, 5 years after initial symptom onset.
Time frame: 1, 3, 5 years
All-cause mortality
All-cause mortality
Time frame: 1, 3, 5 years
The percentage of stroke of undetermined cause at discharge
The percentage of stroke of undetermined cause at discharge
Time frame: 1 year
Rate of antithrombotic therapy at discharge
The rate of patients with cerebral infarction who received antithrombotic drugs (such as aspirin, other antiplatelet agents, heparin, warfarin or new oral anticoagulants) at discharge in the total number of hospitalized patients with cerebral infarction in the same period.
Time frame: 1 year
Rate of anticoagulant treatment for patients with atrial fibrillation at discharge
The rate of patients with cerebral infarction complicated with atrial fibrillation who received anticoagulants (e.g., heparin, low molecular heparin, warfarin, new oral anticoagulants) at discharge in the total number of patients with cerebral infarction complicated with atrial fibrillation treated in hospital in the same period
Time frame: 1 year
Rate of blood vessel assessment within one week of hospitalization
The rate of patients with cerebral infarction hospitalized for 1 week who had completed the evaluation of the blood vessels in the neck and cranial (such as the ultrasound of the blood vessels in the neck or cranial, CT or MR angiography, or DSA) in the total number of cerebral infarction patients hospitalized in the same period
Time frame: 1 year
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