Development and validation of a score for evaluating comprehensive stroke care capabilities

J-ASPECT Study

J-ASPECT Study Collaborators

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Although the Brain Attack Coalition recommended establishing centers of comprehensive care for stroke and cerebrovascular disease patients, a scoring system for such centers was lacking. We created and validated a comprehensive stroke center (CSC) score, adapted to Japanese circumstances.

METHODS: Of the selected 1369 certified training institutions in Japan, 749 completed an acute stroke care capabilities survey. Hospital performance was determined using a 25-item score, evaluating 5 subcategories: personnel, diagnostic techniques, specific expertise, infrastructure, and education. Consistency and validity were examined using correlation coefficients and factorial analysis.

RESULTS: The CSC score (median, 14; interquartile range, 11-18) varied according to hospital volume. The five subcategories showed moderate consistency (Cronbach's α = 0.765). A strong correlation existed between types of available personnel and specific expertise. Using the 2011 Japanese Diagnosis Procedure Combination database for patients hospitalized with stroke, four constructs were identified by factorial analysis (neurovascular surgery and intervention, vascular neurology, diagnostic neuroradiology, and neurocritical care and rehabilitation) that affected in-hospital mortality from ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. The total CSC score was related to in-hospital mortality from ischemic stroke (odds ratio [OR], 0.973; 95% confidence interval [CI], 0.958-0.989), intracerebral hemorrhage (OR, 0.970; 95% CI, 0.950-0.990), and subarachnoid hemorrhage (OR, 0.951; 95% CI, 0.925-0.977), with varying contributions from the four constructs.

CONCLUSIONS: The CSC score is a valid measure for assessing CSC capabilities, based on the availability of neurovascular surgery and intervention, vascular neurology, diagnostic neuroradiology, and critical care and rehabilitation services.

Original languageEnglish
Number of pages1
JournalBMC neurology
Volume17
Issue number1
DOIs
Publication statusPublished - Feb 28 2017

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Stroke
Odds Ratio
Cerebral Hemorrhage
Subarachnoid Hemorrhage
Confidence Intervals
Neurology
Hospital Mortality
Blood Vessels
Rehabilitation
Cerebrovascular Disorders
Critical Care
Japan
Databases
Education
Brain

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Development and validation of a score for evaluating comprehensive stroke care capabilities : J-ASPECT Study. / J-ASPECT Study Collaborators.

In: BMC neurology, Vol. 17, No. 1, 28.02.2017.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Although the Brain Attack Coalition recommended establishing centers of comprehensive care for stroke and cerebrovascular disease patients, a scoring system for such centers was lacking. We created and validated a comprehensive stroke center (CSC) score, adapted to Japanese circumstances.METHODS: Of the selected 1369 certified training institutions in Japan, 749 completed an acute stroke care capabilities survey. Hospital performance was determined using a 25-item score, evaluating 5 subcategories: personnel, diagnostic techniques, specific expertise, infrastructure, and education. Consistency and validity were examined using correlation coefficients and factorial analysis.RESULTS: The CSC score (median, 14; interquartile range, 11-18) varied according to hospital volume. The five subcategories showed moderate consistency (Cronbach's α = 0.765). A strong correlation existed between types of available personnel and specific expertise. Using the 2011 Japanese Diagnosis Procedure Combination database for patients hospitalized with stroke, four constructs were identified by factorial analysis (neurovascular surgery and intervention, vascular neurology, diagnostic neuroradiology, and neurocritical care and rehabilitation) that affected in-hospital mortality from ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. The total CSC score was related to in-hospital mortality from ischemic stroke (odds ratio [OR], 0.973; 95{\%} confidence interval [CI], 0.958-0.989), intracerebral hemorrhage (OR, 0.970; 95{\%} CI, 0.950-0.990), and subarachnoid hemorrhage (OR, 0.951; 95{\%} CI, 0.925-0.977), with varying contributions from the four constructs.CONCLUSIONS: The CSC score is a valid measure for assessing CSC capabilities, based on the availability of neurovascular surgery and intervention, vascular neurology, diagnostic neuroradiology, and critical care and rehabilitation services.",
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AU - J-ASPECT Study Collaborators

AU - Kada, Akiko

AU - Nishimura, Kunihiro

AU - Nakagawara, Jyoji

AU - Ogasawara, Kuniaki

AU - Ono, Junichi

AU - Shiokawa, Yoshiaki

AU - Aruga, Toru

AU - Miyachi, Shigeru

AU - Nagata, Izumi

AU - Toyoda, Kazunori

AU - Matsuda, Shinya

AU - Suzuki, Akifumi

AU - Kataoka, Hiroharu

AU - Nakamura, Fumiaki

AU - Kamitani, Satoru

AU - Iihara, Koji

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