Assessment of compliance with current clinical guidelines on clinical and hardware diagnosis of stroke according to the data of the Vinnytsia register for the period of 2017–2019

S.P. Moskovko, D.O. Fiks, А.V. Shayuk


Background. Carrying out comparative analysis of representative regional data on the level of diagnosis at the hospital stage of stroke management for a certain period of time and between different medical establishments allows us to form correctly a set of medical and preventive measures and to develop consistent recommendations for their improvement. The purpose: to assess the dynamics of quality indicators of clinical and hardware diagnosis of stroke for the period of 2017–2019 and to conduct a comparative analysis between the studied health care institutions. Materials and methods. According to the case histories, a comparative analysis was carried out on the level of organization of clinical and hardware diagnosis in the Municipal Non-Profit Enterprise “Academician O.I. Yushchenko Vinnytsia Regional Clinical Psychoneurological Hospital of Vinnytsia Regional Council” (VRCPNH) and Vinnytsia City Clinical Emergency Hospital (VCCEH) in 2017–2019. Statistical processing of the results was performed using Statistica 5.5 package. Results. Significant differences were found in the number of VRCPNH and VCCEH patients who underwent evaluation of stroke severity on the National Institutes of Health Stroke Scale at hospital stage, neuroimaging in the first hours of the disease, ultrasound of the neck vessels, atrial fibrillation and dysphagia screening, consultations of speech therapist and physiotherapist. In each hospital, there was a positive trend for three years after the completion of all diagnostic measures and procedures. Conclusions. The results of the study confirmed the adequacy of the studied quality indicators and the feasibility of further implementation of the hospital registry method in other regions of Ukraine to assess and control the quality of care, including the analysis of the effectiveness of new technologies.


stroke; computed tomography; dysphagia screening; atrial fibrillation; speech therapist; physio-therapist

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Starodubtseva O.S., Begicheva S.V. Analiz zabolevaemosti insultom s ispolzovaniem informatsionnyih tehnologiy. Fundamentalnyie issledovaniya. 2012. 8(2). 424-427 (in Russian).

Musuka T.D., Wilton S.B., Traboulsi M., Hill M.D. Diagnosis and management of acute ischemic stroke: speed is critical. CMAJ. 2015. 187(12). 887-893.

Tong E., Hou Q., Fiebach J.B., Wintermark M. The role of imaging in acute ischemic stroke. Neurosurg. Focus. 2014. 36(1). E3.

Davis S., Donnan G.A. Time is penumbra: imaging, selection and outcome. Cerebrovasc. Dis. 2014. 38(1). 59-72.

Khanal K., Bhandari S.S., Shrestha N., Acharya S.P., Marhatta M.N. Comparison of outcome predictions by the Glasgow coma scale and the Full Outline of UnResponsiveness score in the neurological and neurosurgical patients in the intensive care unit. Indian J. Crit. Care Med. 2016. 20(8). 473-476.

Aldatov R.H., Trufanov G.E., Fokin V.A. Neyrovizualizatsiya ostrogo ishemicheskogo insulta: sovremennoe sostoyanie. Translyatsionnaya meditsina. 2019. 6(2). 12-17 (in Russian).

O’Donnell M.J., Chin S.L., Rangarajan S. et al. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. The Lancet. 2016. 388(10046). 761-775.

Feigin V.L., Norrving B., George M.G., Foltz J.L., Roth G.A., Mensah G.A. Prevention of stroke: a strategic global imperative. Nature Reviews Neurology. 2016. 12(9). 501-512.

Bokeriya L.A. Natsionalnyie rekomendatsii po vedeniyu patsientov s zabolevaniyami brahiotsefalnyih arteriy. M.: Meditsina, 2013. 72 s. (in Russian).

Smith E.E., Kent D.V., Bulsara K.R. et al. Effect of dysphagia screening strategies on clinical outcomes after stroke: a systematic review for the 2018 guidelines for the early management of patients with acute ischemic stroke. Stroke. 2018. 49(3). е123-е128.

Newman R., Vilardell N., Clavé P., Speyer R. Effect of bolus viscosity on the safety and efficacy of swallowing and the kinematics of the swallow response in patients with oropharyngeal dysphagia: White Paper by the European Society for Swallowing Disorders (ESSD). Dysphagia. 2016. 31(2). 232-249.

Murashko N.K., Shklyaeva O.N. Kliniko-nevrologichni osoblivosti rozvitku ishemichnogo insultu u hvorih z fibrilyatsieyu peredserd. Likarska sprava. 2013. 1. 77-81 (in Ukrainian).

Tibekina L.M., Ashurko O.A. Osobennosti rabotyi logopeda v sosudistom tsentre mnogoprofilnogo statsionara. Zdorove — osnova chelovecheskogo potentsiala: problemyi i puti ih resheniya. 2014. 2. 547-549 (in Russian).

Pollock A., Baer G., Campbell P. et al. Physical rehabilitation approaches for the recovery of function and mobility following stroke. Cochrane Database Syst. Rev. 2014. (4).

Lekander I., Willers C., Ekstrand E. et al. Hospital comparison of stroke care in Sweden: a register-based study. BMJ Open. 2017. 7(9). e015244.

Karabıyık L. Intensive care scoring systems. Turkish Journal of Intensive Care Medicine. 2010. 9(3). 129-143.

Bill O., Zufferey P., Faouzi M., Michel P. Severe stroke: patient profile and predictors of favorable outcome. J. Thromb. Haemost. 2013. 11. 92-99.

Gao J., Parsons M.W., Kawano H. et al. Visibility of CT early ischemic change is significantly associated with time from stroke onset to baseline scan beyond the first 3 hours of stroke onset. J. Stroke. 2017. 19(3). 340-346.

Jauch E.C., Saver J.L., Adams H.P. et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013. 44(3). 870-947.

Peltola M., Seppälä T.T., Malmivaara A. et al. Individual and regional-level factors contributing to variation in length of stay after cerebral infarction in six European countries. Health Econ. 2015. 24(2). 38-52.

Rost N.S., Bottle A., Lee J.M. et al. Stroke severity is a crucial predictor of outcome: an international prospective validation study. J. Am. Heart Assoc. 2016. 5(1). е002433.

Bacigalupe A., Escolar-Pujolar A. The impact of economic crises on social inequalities in health: what do we know so far? International Journal for Equity in Health. 2014. 13(1). 52.

Kamalian S., Lev M.H. Stroke imaging. Radiol. Clin. North Am. 2019. 57(4). 717-732.

Zerna C., Thomalla G., Campbell B.C., Rha J.H., Hill M.D. Current practice and future directions in the diagnosis and acute treatment of ischaemic stroke. The Lancet. 2018. 392(10154). 1247-1256.

Saqqur M., Khan K., Derksen C., Alexandrov A., Shuaib A. Transcranial Doppler and transcranial color duplex in defining collateral cerebral blood flow. J. Neuroimaging. 2018. 28(5). 455-476.

Ringborg A., Nieuwlaat R., Lindgren P. et al. Costs of atrial fibrillation in five European countries: results from the Euro Heart Survey on atrial fibrillation. Europace. 2008. 10(4). 403-411.

Myimrenko S.N. Fibrillyatsiya predserdiy: voprosyi patogeneza, algoritmyi diagnostiki, klinicheskaya znachimost, strategii lecheniya. Chast 1. Liki Ukrayini. 2014. 2. 27-33 (in Russian).

Paciaroni M., Agnelli G., Caso V. et al. Causes and risk factors of cerebral ischemic events in patients with atrial fibrillation treated with non-vitamin k antagonist oral anticoagulants for stroke prevention: the RENo study. Stroke. 2019. 50(8). 2168-2174.

Wortman-Jutt S., Edwards D. Poststroke aphasia rehabilitation: why all talk and no action? Neurorehabilitation and Neural Repair. 2019. 33(4). 235-244.

Tong Y., Cheng Z., Rajah G.B. et al. High intensity physical rehabilitation later than 24 h post stroke is beneficial in patients: a pilot randomized controlled trial (RCT) study in mild to moderate ischemic stroke. Front. Neurol. 2019. 10. 113.


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