Observational studyBMJ open2019
Analysis on geographic variations in hospital deaths and endovascular therapy in ischaemic stroke patients: an observational cross-sectional study in China.
Observational study in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Pooled it
- Variations in Methodological Approaches to Measuring Health Inequalities and Inequities: A Scoping Review of Acute Stroke Pathways.Healthcare (Basel, Switzerland) · 2025Review
- Regional Disparities in Hyperacute Treatment and Functional Outcomes after Acute Ischemic Stroke in Japan.Journal of atherosclerosis and thrombosis · 2024Article
- Geographic differences in pharmacotherapy patterns and outcomes of acute ischemic stroke in China.BMC neurology · 2024Article
- Peripheral Lymphocyte-to-Monocyte Ratio as a Predictive Factor for Early Neurological Deterioration in Patients with Acute Ischemic Stroke.International journal of general medicine · 2024Article
- Article
- Rates of intravenous thrombolysis and endovascular therapy for acute ischaemic stroke in China between 2019 and 2020.The Lancet regional health. Western Pacific · 2022Article
- The Bigger the Better? Center Volume Dependent Effects on Procedural and Functional Outcome in Established Endovascular Stroke Centers.Frontiers in neurology · 2022Article
- Regional Disparity of Reperfusion Therapy for Acute Ischemic Stroke in Japan: A Retrospective Analysis of Nationwide Claims Data from 2010 to 2015.Journal of the American Heart Association · 2021Article
- Patient Representation From Structured Electronic Medical Records Based on Embedding Technique: Development and Validation Study.JMIR medical informatics · 2021Article
- Immediate Effect of Dry Needling at Myofascial Trigger Point on Hand Spasticity in Chronic Post-stroke Patients: A Multicenter Randomized Controlled Trial.Frontiers in neurology · 2021Article
- Regional Differences in Hospital Costs of Acute Ischemic Stroke in China: Analysis of Data From the Chinese Acute Ischemic Stroke Treatment Outcome Registry.Frontiers in public health · 2021Article
- Characteristics of acute ischemic stroke in hospitalized patients in Tibet: a retrospective comparative study.BMC neurology · 2020Article
- Public satisfaction with the healthcare system in China during 2013-2015: a cross-sectional survey of the associated factors.BMJ open · 2020Article
- Regional disparities and hospital performance patterns in acute stroke reperfusion: a multicenter study in Sichuan Province, China.Frontiers in neurologyArticle
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesStroke is the leading cause of death and adult disability in China, following a rise in incidence over the last few decades. We aimed to explore the geographic variations in hospital mortality and endovascular therapy (EVT) use among ischaemic stroke (IS) patients in China, and investigate the associated potential risk factors.
designObservational cross-sectional study of patients hospitalised for stroke.
settingHospital discharge data for 1267 tertiary hospitals between 1 January 2015 and 31 December 2015 were derived from the Nationwide Hospital Discharge Database operated by the National Health Commission of China.
participants1 826 332 patients aged ≥18 years, hospitalised following stroke. OUTCOME MEASURES: In-hospital mortality and EVT use.
resultsThe nationwide hospital mortality rate of IS patients was 0.88% (95% CI 0.86% to 0.90%); there was a significantly greater risk of mortality in the Northeast (OR 2.37; 95% CI 2.23 to 2.52), West (1.65; 1.54 to 1.78), South (1.25; 1.17 to 1.33) and North (1.29; 1.20 to 1.39) than in the East. Tertiary B hospitals (OR 1.05; 95% CI 1.00 to 1.09), patients admitted from emergency departments and older patients were associated with higher hospital mortality. The national EVT use rate was 0.45% (95% CI 0.44% to 0.46%). Compared with in East China, EVT use was significantly lower in the Northeast (OR 0.22; 95% CI 0.20 to 0.24) and West (0.64; 0.58 to 0.71), though not the North (1.23; 1.14 to 1.33). Tertiary A hospitals (OR 2.62; 95% CI 2.43 to 2.83), male patients and patients admitted from emergency departments were also associated with higher EVT use rates.
conclusionsThere were substantial disparities in mortality and EVT use for hospitalised patients with IS among China's tertiary hospitals, linked with both geographic and hospital characteristics. More targeted intervention at regional and hospital levels is needed for providing effective health technologies and eventually improving post-stroke outcomes.
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