Stroke Prevention and Treatment System in Shanghai: a Network of Public Healthcare of Stroke

NCT ID: NCT02735226

Last Updated: 2017-07-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

100000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-01-31

Study Completion Date

2018-12-31

Brief Summary

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The Shanghai Stroke Service System(4S) has been established as the network of stroke care in greater Shanghai metropolitan area. The system includes 11 territorial-care hospitals and their comprehensive stroke unites that provide 24h/7day acute stroke care to a population of 40 million in Shanghai. The System comprised of two consecutive phases, the acute phase that emphasized on providing thrombolysis, and the in-hospital phase that concentrated on the effort of recovery and secondary stroke prevention. The novel electronic data aquisition system provides the contiguous data of clinical care of stroke patients from the acute phase of management to inpatient rehabilitation. This system has been implemented and maintained as an ongoing quality of stroke care project that monitored the process of routine stroke care in Shanghai. It is funded by the Shanghai Municipal Commission of Health and Family Planning. Our analysis of the project was approved by the Ethics Committee, which agreed that no written informed consents were needed since the study only was consisted of a population-based retrospective data analysis.

Detailed Description

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The goal of Shanghai stroke service system is to promote and facilitate high quality standardized stroke care in Shanghai area. The 11 hospitals involved are committed to provide the best stroke care to their patients. This quality goal consists of two parts: the acute phase of stroke care and the subsequent care during the hospitalization. To accomplish this goal, each hospital has organized a multidisciplinary stroke team that will address day-to-day stroke care. Each hospital provides prioritized neuroimaging service to patients with acute stroke 24hr per day, 7days per week. A stroke neurologist is on site 24hr per day, 7 days per week in each hospital. This team will follow the guidelines to carry out standardized secondary stroke prevention once the patient has been admitted.

The stroke clinical pathway is available on line in computers of each hospital. This pathway can be accessed from hospital computers, or from outside.

Stroke team members in each hospital obtained and entered all data on each stroke patient: demographics, stroke onset time, onset to thrombolytic time, presenting NIHSS, timing of diagnostic procedures, treatment strategies, performance of quality measures, comorbidities, in-hospital mortality, etc. These data are contained in a three-page form, which are embedded in the electronic health record of each patient.

If ICD-10 stroke codes were entered as the primary discharge diagnoses, the electronic health record systems would not allow the discharge of the patient until all required documentation has been completed. The EHR would not allow for any empty fields before it could be closed. Data quality was assured by automatic feasibility checks. The novel electronic data acquisition system provides the continuous clinical care data on all stroke patients from their acute management phase to inpatient rehabilitation or discharge.

Conditions

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Stroke

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Acute Stroke patient

Patients who are presented to hospital within 7days from onset. The key measurement of clinical quality controlled in patients with acute stroke managment and inhouse stroke care were record automatically

stroke network and policy intervention

Intervention Type OTHER

Shanghai stroke service and network contributes to update the ability of stroke care of comprehensive and primary stroke center,to improve radiation ability of comprehensive stroke centers and try to form a close relationship between comprehensive stroke centers and its primary stroke centers.

Interventions

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stroke network and policy intervention

Shanghai stroke service and network contributes to update the ability of stroke care of comprehensive and primary stroke center,to improve radiation ability of comprehensive stroke centers and try to form a close relationship between comprehensive stroke centers and its primary stroke centers.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* 18 years old or older
* primary diagnosis as acute stroke or TIA within 7 days from onset
* admitted in stroke unit.

Exclusion Criteria

* child or teenager younger than 18 years old
* woman with pregnant
* outpatient
* any other reason that patient cannot be admitted for secondary prevention
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Huashan Hospital

OTHER

Sponsor Role collaborator

Shanghai Zhongshan Hospital

OTHER

Sponsor Role collaborator

Ruijin Hospital

OTHER

Sponsor Role collaborator

theTenth People's Hospital

UNKNOWN

Sponsor Role collaborator

the Sixth People's Hospital

AMBIG

Sponsor Role collaborator

RenJi Hospital

OTHER

Sponsor Role collaborator

ShuGuang Hospital

OTHER

Sponsor Role collaborator

Dongfang Hospital Beijing University of Chinese Medicine

OTHER

Sponsor Role collaborator

Changzheng Hospital

UNKNOWN

Sponsor Role collaborator

Changhai Hospital

OTHER

Sponsor Role collaborator

the Ninth People's Hospital

UNKNOWN

Sponsor Role collaborator

Shanghai Stroke Service System

OTHER

Sponsor Role lead

Responsible Party

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Qiang Dong

Director of Shanghai Stroke Service system

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Qiang Dong, M.D., Ph.D

Role: PRINCIPAL_INVESTIGATOR

Shanghai Stroke Service System

Locations

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Zhongshan Hospital affiliated to Fudan University

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Huashan Hospital,Fudan University

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Shuguang Hospital affiliated to Shanghai Traditional Chinese Medicine University

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

The Shanghai Tenth People's Hospital, Tongji University

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Dongfang Hospital affiliated to Shanghai University of TCM

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Renji hospital,Shanghai Jiaotong University School of Medicine

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Shanghai Changhai Hospital

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Shanghai Changzheng Hospital

Shanghai, Shanghai Municipality, China

Site Status ACTIVE_NOT_RECRUITING

Shanghai Jiao Tong University School of Medicine Ruijin Hospital

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

The Sixth People's Hospital affiliated to Shanghai Jiaotong University

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Yi Dong, M.D

Role: CONTACT

86-21-52887145

Kun Fang, M.D

Role: CONTACT

86-21-52887146

Facility Contacts

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Xin Wang, M.D.,Ph.D.

Role: primary

13501909896

Qiang Dong, M.D., Ph.D.

Role: primary

86-13701875129

Yi Dong, M.D.

Role: backup

86-13916665674

Xiaofei Yu, M.D.,Ph.D.

Role: primary

13331978806

Xueyuan Liu

Role: primary

13564578127

Gang Li, M.D.

Role: primary

13621691786

Changsong Li

Role: backup

13122751682

Yangtai Guan, Ph.D., M.D.

Role: primary

13386271865

Ying Chen

Role: backup

13501763660

Benqiang Deng, M.D.

Role: primary

13701936570

Yi Fu

Role: primary

86-021-64370045

Shufen Chen

Role: backup

1379532986

Jianren Liu, M.D.

Role: primary

Yuwu Zhao, M.D.

Role: primary

15901713716

Hongmei Wang

Role: backup

18930177606

References

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Xu J, Xie Y, Fang K, Wang X, Chen S, Liu X, Zhao Y, Guan Y, Cai D, Li G, Liu J, Liu J, Zhuang J, Xian Y, Shen H, Li H, Wang DZ, Campbell BC, Parsons MW, Dong Y, Dong Q. Effect of the Shanghai Stroke Service System (4S) on the quality of stroke care and outcomes: A prospective quality improvement project. Int J Stroke. 2023 Jun;18(5):599-606. doi: 10.1177/17474930221125993. Epub 2022 Oct 15.

Reference Type DERIVED
PMID: 36082948 (View on PubMed)

Dong Y, Han Y, Shen H, Wang Y, Ma F, Li H, Wang Y, Dong Q. Who may benefit from lower dosages of intravenous tissue plasminogen activator? Results from a cluster data analysis. Stroke Vasc Neurol. 2020 Dec;5(4):348-352. doi: 10.1136/svn-2020-000388. Epub 2020 Jul 1.

Reference Type DERIVED
PMID: 32611728 (View on PubMed)

Dong Y, Fang K, Wang X, Chen S, Liu X, Zhao Y, Guan Y, Cai D, Li G, Liu J, Liu J, Zhuang J, Wang P, Chen X, Shen H, Wang DZ, Xian Y, Feng W, Campbell BC, Parsons M, Dong Q. The network of Shanghai Stroke Service System (4S): A public health-care web-based database using automatic extraction of electronic medical records. Int J Stroke. 2018 Jul;13(5):539-544. doi: 10.1177/1747493018765492. Epub 2018 Mar 21.

Reference Type DERIVED
PMID: 29561219 (View on PubMed)

Other Identifiers

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Shanghai Stroke Service System

Identifier Type: -

Identifier Source: org_study_id

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