The Gaps Between Current Management of Intracerebral Hemorrhage and Evidence-Based Practice Guidelines in Beijing, China
Background: The leading cause of death in China is stroke, a condition that also contributes heavily to the disease burden. Nontraumatic intracerebral hemorrhage (ICH) is the second most common cause of stroke. Compared to Western countries, in China the proportion of ICH is significantly higher. St...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2018-12-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2018.01091/full |
| _version_ | 1819138771699892224 |
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| author | Di Li Di Li Haixin Sun Haixin Sun Xiaojuan Ru Xiaojuan Ru Dongling Sun Dongling Sun Xiuhua Guo Xiuhua Guo Bin Jiang Bin Jiang Yanxia Luo Yanxia Luo Lixin Tao Lixin Tao Jie Fu Jie Fu Wenzhi Wang Wenzhi Wang |
| author_facet | Di Li Di Li Haixin Sun Haixin Sun Xiaojuan Ru Xiaojuan Ru Dongling Sun Dongling Sun Xiuhua Guo Xiuhua Guo Bin Jiang Bin Jiang Yanxia Luo Yanxia Luo Lixin Tao Lixin Tao Jie Fu Jie Fu Wenzhi Wang Wenzhi Wang |
| author_sort | Di Li |
| collection | DOAJ |
| description | Background: The leading cause of death in China is stroke, a condition that also contributes heavily to the disease burden. Nontraumatic intracerebral hemorrhage (ICH) is the second most common cause of stroke. Compared to Western countries, in China the proportion of ICH is significantly higher. Standardized treatment based on evidence-based medicine can help reduce ICH's burden. In the present study we aimed to explore the agreement between the management strategies during ICH's acute phase and Class I recommendations in current international practice guidelines in Beijing (China), and to elucidate the reasons underlying any inconsistencies found.Method: We retrospectively collected in-hospital data from 1,355 ICH patients from 15 hospitals in Beijing between January and December 2012. Furthermore, a total of 75 standardized questionnaires focusing on ICH's clinical management were distributed to 15 cooperative hospitals. Each hospital randomly selected five doctors responsible for treating ICH patients to complete the questionnaires.Results: Numerous approaches were in line with Class I recommendations, as follows: upon admission, all patients underwent radiographic examination, about 93% of the survivors received health education and 84.5% of those diagnosed with hypertension were prescribed antihypertensive treatment at discharge, in-hospital antiepileptic drugs were administered to 91.8% of the patients presenting with seizures, and continuous monitoring was performed for 88% of the patients with hyperglycemia on admission. However, several aspects were inconsistent with the guidelines, as follows: only 14.2% of the patients were initially managed in the neurological intensive care unit and 22.3% of the bedridden patients received preventive treatment for deep vein thrombosis (DVT) within 48 h after onset. The questionnaire results showed that imaging examination, blood glucose monitoring, and secondary prevention of ICH were useful to more clinicians. However, the opposite occurred for the neurological intensive care unit requirement. Regarding the guidelines' recognition, no significant differences among the 3 education subgroups were observed (p > 0.05).Conclusions: Doctors have recognized most of ICH's evidence-based practice guidelines. However, there are still large gaps between the management of ICH and the evidence-based practice guidelines in Beijing (China). Retraining doctors is required, including focusing on preventing DVT providing a value from the National Institutes of Health Stroke Scale and Glasgow Coma Scalescores at the time of admission. |
| first_indexed | 2024-12-22T11:12:04Z |
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| language | English |
| last_indexed | 2024-12-22T11:12:04Z |
| publishDate | 2018-12-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-a1035ce66f2949cbb0d062a2899f35a92022-12-21T18:28:08ZengFrontiers Media S.A.Frontiers in Neurology1664-22952018-12-01910.3389/fneur.2018.01091415737The Gaps Between Current Management of Intracerebral Hemorrhage and Evidence-Based Practice Guidelines in Beijing, ChinaDi Li0Di Li1Haixin Sun2Haixin Sun3Xiaojuan Ru4Xiaojuan Ru5Dongling Sun6Dongling Sun7Xiuhua Guo8Xiuhua Guo9Bin Jiang10Bin Jiang11Yanxia Luo12Yanxia Luo13Lixin Tao14Lixin Tao15Jie Fu16Jie Fu17Wenzhi Wang18Wenzhi Wang19Beijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaBeijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, ChinaBeijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaBeijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, ChinaBeijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaBeijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, ChinaBeijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaBeijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, ChinaBeijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, ChinaSchool of Public Health, Capital Medical University, Beijing, ChinaBeijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaBeijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, ChinaBeijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, ChinaSchool of Public Health, Capital Medical University, Beijing, ChinaBeijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, ChinaSchool of Public Health, Capital Medical University, Beijing, ChinaBeijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaBeijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, ChinaBeijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaBeijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, ChinaBackground: The leading cause of death in China is stroke, a condition that also contributes heavily to the disease burden. Nontraumatic intracerebral hemorrhage (ICH) is the second most common cause of stroke. Compared to Western countries, in China the proportion of ICH is significantly higher. Standardized treatment based on evidence-based medicine can help reduce ICH's burden. In the present study we aimed to explore the agreement between the management strategies during ICH's acute phase and Class I recommendations in current international practice guidelines in Beijing (China), and to elucidate the reasons underlying any inconsistencies found.Method: We retrospectively collected in-hospital data from 1,355 ICH patients from 15 hospitals in Beijing between January and December 2012. Furthermore, a total of 75 standardized questionnaires focusing on ICH's clinical management were distributed to 15 cooperative hospitals. Each hospital randomly selected five doctors responsible for treating ICH patients to complete the questionnaires.Results: Numerous approaches were in line with Class I recommendations, as follows: upon admission, all patients underwent radiographic examination, about 93% of the survivors received health education and 84.5% of those diagnosed with hypertension were prescribed antihypertensive treatment at discharge, in-hospital antiepileptic drugs were administered to 91.8% of the patients presenting with seizures, and continuous monitoring was performed for 88% of the patients with hyperglycemia on admission. However, several aspects were inconsistent with the guidelines, as follows: only 14.2% of the patients were initially managed in the neurological intensive care unit and 22.3% of the bedridden patients received preventive treatment for deep vein thrombosis (DVT) within 48 h after onset. The questionnaire results showed that imaging examination, blood glucose monitoring, and secondary prevention of ICH were useful to more clinicians. However, the opposite occurred for the neurological intensive care unit requirement. Regarding the guidelines' recognition, no significant differences among the 3 education subgroups were observed (p > 0.05).Conclusions: Doctors have recognized most of ICH's evidence-based practice guidelines. However, there are still large gaps between the management of ICH and the evidence-based practice guidelines in Beijing (China). Retraining doctors is required, including focusing on preventing DVT providing a value from the National Institutes of Health Stroke Scale and Glasgow Coma Scalescores at the time of admission.https://www.frontiersin.org/article/10.3389/fneur.2018.01091/fullintracerebral hemorrhagemanagement strategiesinternational practice guidelinesgapquestionnaire |
| spellingShingle | Di Li Di Li Haixin Sun Haixin Sun Xiaojuan Ru Xiaojuan Ru Dongling Sun Dongling Sun Xiuhua Guo Xiuhua Guo Bin Jiang Bin Jiang Yanxia Luo Yanxia Luo Lixin Tao Lixin Tao Jie Fu Jie Fu Wenzhi Wang Wenzhi Wang The Gaps Between Current Management of Intracerebral Hemorrhage and Evidence-Based Practice Guidelines in Beijing, China Frontiers in Neurology intracerebral hemorrhage management strategies international practice guidelines gap questionnaire |
| title | The Gaps Between Current Management of Intracerebral Hemorrhage and Evidence-Based Practice Guidelines in Beijing, China |
| title_full | The Gaps Between Current Management of Intracerebral Hemorrhage and Evidence-Based Practice Guidelines in Beijing, China |
| title_fullStr | The Gaps Between Current Management of Intracerebral Hemorrhage and Evidence-Based Practice Guidelines in Beijing, China |
| title_full_unstemmed | The Gaps Between Current Management of Intracerebral Hemorrhage and Evidence-Based Practice Guidelines in Beijing, China |
| title_short | The Gaps Between Current Management of Intracerebral Hemorrhage and Evidence-Based Practice Guidelines in Beijing, China |
| title_sort | gaps between current management of intracerebral hemorrhage and evidence based practice guidelines in beijing china |
| topic | intracerebral hemorrhage management strategies international practice guidelines gap questionnaire |
| url | https://www.frontiersin.org/article/10.3389/fneur.2018.01091/full |
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