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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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Background and Purpose Recombinant tissue plasminogen activator (rtPA) is one of the proventherapies that improve the outcome of patients with acute ischemic stroke (AIS). In 2009, theMinistry of Health and Welfare, Executive Yuan, Republic of China, launched the project “HospitalEmergent Capability Accreditation by Level-Stroke (HECAL-Stroke)” to improve AIS treatment inTaiwan. The current study was performed to determine whether the project launched by thegovernment was effective in promoting rtPA therapy among AIS patients.
Methods All participating hospitals were verified and designated as “heavy duty (HD),” “moderateduty (MoD),” or “medium duty (MeD)” according to the stroke center criteria. Four annual indices(rates of treatment, protocol adherence, in-time treatment, and complications) were recorded from2009 to 2014 as outcome measures. The data were analyzed using the χ2 test for significance.
Results The number of certified hospitals progressively increased from 74 to 112 during the 6-yearperiod and finally consisted of 33 HD, 9 MoD and 70 MeD hospitals in 2014. The annualintravenous rtPA treatment rate increased significantly from 3.0% in 2009 to 4.5% in 2014. Theprotocol adherence rates were 95.7% in the HD group, 92.4% in the MoD group and 72.8% in theMeD group. The annual in-time treatment rate significantly improved from 26.0% in 2009 to60.1% in 2014. The overall symptomatic intracranial hemorrhagic rate after rtPA treatment was8.6%.
Conclusions Initiation of the HECAL-Stroke project by the government significantly improved rtPAtreatment in Taiwan.
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참고문헌 (22)
참고문헌 신청
Albers GW / 2000 / Intravenous tissue-type plasminogen activator for treatment of acute stroke: the Standard Treatment with Alteplase to Reverse Stroke (STARS) study / JAMA
Alberts MJ / 2011 / Revised and updated recommendations for the establishment of primary stroke centers: a summary statement from the brain attack coalition / Stroke 42 : 265
Bluhmki E / 2009 / Stroke treatment with alteplase given 3.0-4.5 h after onset of acute ischaemic stroke (ECASS III): additional outcomes and subgroup analysis of a randomise
Chang KC / 2004 / Prehospital delay after acute stroke in Kaohsiung, Taiwan / Stroke 35 : 700 ~ 704
Cheng TJ / 2010 / The association between arsenic exposure from drinking water and cerebrovascular disease mortality in Taiwan / Water Res 44 : 5770 ~ 5776
Alberts MJ / 2011 / Revised and updated recommendations for the establishment of primary stroke centers: a summary statement from the brain attack coalition / Stroke 42 : 265
Bluhmki E / 2009 / Stroke treatment with alteplase given 3.0-4.5 h after onset of acute ischaemic stroke (ECASS III): additional outcomes and subgroup analysis of a randomise
Chang KC / 2004 / Prehospital delay after acute stroke in Kaohsiung, Taiwan / Stroke 35 : 700 ~ 704
Cheng TJ / 2010 / The association between arsenic exposure from drinking water and cerebrovascular disease mortality in Taiwan / Water Res 44 : 5770 ~ 5776
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