A Prototype Worldwide Survey of Diagnostic and Treatment Modalities for Stroke

Venkatesh Aiyagari, Dilip K. Pandey, Fernando D. Testai, Rebbeca A. Grysiewicz, Alexander Tsiskaridze, Claudio Sacks, Yomi Ogun, Olubunmi A. Ogunrin, Basim M. Uthman, Patrice Lindsay, Philip B. Gorelick

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Stroke is a global health problem. However, very little is known about stroke care in low- to middle-income countries. Obtaining country-specific information could enable us to develop targeted programs to improve stroke care. We surveyed neurologists from 12 countries (Chile, Georgia, Nigeria, Qatar, India, Lithuania, Kazakhstan, Indonesia, Denmark, Brazil, Belgium, and Bangladesh) using a web-based survey tool. Data were analyzed both for individual countries and by income classification (low income, lower middle income, upper middle income, and high income). Six percent (n = 200) of 3123 targeted physicians completed the survey. There was a significant correlation between income classification and access and affordability of head computed tomography scan (ρ =.215, P =.002), transthoracic echocardiogram (ρ =.181, P =.012), extracranial carotid Doppler ultrasound (ρ =.312, P ≤&.000), cardiac telemetry (ρ =.353, P ≤;.000), and stroke treatments such as intravenous thrombolysis (ρ =.276, P ≤&.001), and carotid endarterectomy (ρ =.214, P ≤;.004); stroke quality measures such as venous thromboembolism prophylaxis during hospital stay (ρ =.163, P ≤&;022), discharge from hospital on antithrombotic therapy (ρ =.266, P ≤;.000), consideration for acute thrombolytic therapy (ρ =.358, P ≤&;000), and antithrombotic therapy prescribed by end of hospital day 2 (ρ =.334, P ≤;.000). However, there was no significant correlation between income classification and the access and affordability of antiplatelet agents, vitamin K antagonists and statins, anticoagulation for atrial fibrillation/flutter, statin medication, stroke education, and assessment for rehabilitation. Our study shows that it is possible to get an overview of stroke treatment measures in different countries by conducting an internet-based survey. The generalizability of the findings may be limited by the low survey response rate.

Original languageEnglish (US)
Pages (from-to)290-296
Number of pages7
JournalJournal of Stroke and Cerebrovascular Diseases
Volume24
Issue number2
DOIs
StatePublished - Feb 1 2015

Keywords

  • Stroke
  • acute treatment of stroke
  • clinical protocols
  • health care surveys
  • stroke prevention

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Aiyagari, V., Pandey, D. K., Testai, F. D., Grysiewicz, R. A., Tsiskaridze, A., Sacks, C., Ogun, Y., Ogunrin, O. A., Uthman, B. M., Lindsay, P., & Gorelick, P. B. (2015). A Prototype Worldwide Survey of Diagnostic and Treatment Modalities for Stroke. Journal of Stroke and Cerebrovascular Diseases, 24(2), 290-296. https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.08.002