Evidence map›Paper›PMID 32764079›Full record

ArticleBMJ open2020

Temporal trends and geographical disparities in comprehensive stroke centre capabilities in Japan from 2010 to 2018.

Ai Kurogi, Ataru Nishimura, Kunihiro Nishimura, Akiko Kada, Daisuke Onozuka, Akihito Hagihara, Kuniaki Ogasawara, Yoshiaki Shiokawa, Takanari Kitazono, Koichi Arimura and 2 more

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Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ai KurogiDepartment of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.ORCID 0000-0002-2740-0990
Ataru NishimuraDepartment of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Kunihiro NishimuraDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Akiko KadaDepartment of Clinical Trials and Research, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Daisuke OnozukaDepartment of Health Communication, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.ORCID 0000-0001-9596-9188
Akihito HagiharaDepartment of Health Communication, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Kuniaki OgasawaraDepartment of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan.
Yoshiaki ShiokawaDepartment of Neurosurgery, Kyorin University Hospital, Mitaka, Tokyo, Japan.
Takanari KitazonoDepartment of Medicine and Clinical Science, Kyusyu University Graduate School of Medicine, Fukuoka, Japan.
Koichi ArimuraDepartment of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Koji IiharaDepartment of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan kiihara@ns.med.kyushu-u.ac.jp.
J-ASPECT Study Collaborators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesComprehensive stroke centre (CSC) capabilities are associated with reduced in-hospital mortality due to acute stroke. However, it remains unclear whether there are improving trends in the CSC capabilities or how hospital-related factors determine quality improvement. This study examined whether CSC capabilities changed in Japan between 2010 and 2018 and and whether any changes were influenced by hospital characteristics.

designA hospital-based cross-sectional study.

settingWe sent out questionnaires to the training institutions of the Japan Neurosurgical Society and Japan Stroke Society in 2010, 2014 and 2018.

participants749 hospitals in 2010, 532 hospitals in 2014 and 786 hospitals in 2018 participated in the J-ASPECT study, a nationwide survey of acute stroke care capacity for proper designation of a comprehensive stroke centre in Japan.

main outcome measuresCSC capabilities were assessed using the validated scoring system (CSC score: 1-25 points) in 2010, 2014 and 2018 survey. The effect of hospital characteristics was examined using multiple logistic regression analysis.

resultsAmong the 323 hospitals that responded to all surveys, the implementation of 13 recommended items increased. The CSC score (median and IQR) was 16 (13-19), 18 (14-20) and 19 (15-21) for 2010, 2014 and 2018, respectively (p<0.001). There was a ≥20% increase in six items (eg, endovascular physicians, stroke unit and interventional coverage 24/7), and a ≤20% decrease in community education. A lower baseline CSC score (OR: 0.82, 95% CI 0.75 to 0.9), the number of beds≥500 (OR: 3.9, 95% CI 1.2 to 13.0) and the number of stroke physicians (7-9) (OR: 2.6, 95% CI 1.1 to 6.3) were associated with improved CSC capabilities, independent of geographical location.

conclusionsThere was a significant improvement in CSC capabilities between 2010 and 2018, which was mainly related to the availability of endovascular treatment and multidisciplinary care. Our findings may be useful to determine which hospitals should be targeted to improve CSC capabilities in a defined area.

Indexed as

StrokeCross-Sectional StudiesHospital MortalityHospitalsHumansJapancomprehensive stroke centerstrokestroke medicinetrends

Identifiers

PMID32764079
PMCPMC7412582

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