The impact of acute stroke service centralisation:: a time series evaluation

Mat Elameer; Christopher Price; Darren Flynn; Helen Rodgers

doi:10.7861/futurehosp.5-3-181

The impact of acute stroke service centralisation: a time series evaluation

Mat Elameer, Christopher Price, Darren Flynn, Helen Rodgers^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

We evaluated the impact of the centralisation of three acute stroke units into a single hyperacute stroke unit within a large urban and rural NHS trust in North East England in June 2015. We performed retrospective interrupted time series analyses of 4,305 stroke patients admitted between 1 April 2013 and 31 December 2017 utilising data recorded for the Sentinel Stroke National Audit Programme. Centralisation was associated with reductions in total length of inpatient stay (–4.9 days [95% CI: –8.1 to –1.7]). Time from admission to thrombolysis shortened by 26.0 minutes (95% CI: –40.0 to –12.1), and time from admission to brain imaging for thrombolysed patients improved by 16.2 minutes (95% CI: –22.0 to –10.4). Time from stroke onset to hospital admission, mortality and dependency (as measured by median modified Rankin Scale) were unaffected by centralisation. This study provides further evidence to support the centralisation of acute stroke services in England.

Original language	English
Pages (from-to)	181-187
Number of pages	7
Journal	Future Healthcare Journal
Volume	5
Issue number	3
DOIs	https://doi.org/10.7861/futurehosp.5-3-181
Publication status	Published - 1 Oct 2018
Externally published	Yes

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Cite this

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title = "The impact of acute stroke service centralisation:: a time series evaluation",

abstract = "We evaluated the impact of the centralisation of three acute stroke units into a single hyperacute stroke unit within a large urban and rural NHS trust in North East England in June 2015. We performed retrospective interrupted time series analyses of 4,305 stroke patients admitted between 1 April 2013 and 31 December 2017 utilising data recorded for the Sentinel Stroke National Audit Programme. Centralisation was associated with reductions in total length of inpatient stay (–4.9 days [95% CI: –8.1 to –1.7]). Time from admission to thrombolysis shortened by 26.0 minutes (95% CI: –40.0 to –12.1), and time from admission to brain imaging for thrombolysed patients improved by 16.2 minutes (95% CI: –22.0 to –10.4). Time from stroke onset to hospital admission, mortality and dependency (as measured by median modified Rankin Scale) were unaffected by centralisation. This study provides further evidence to support the centralisation of acute stroke services in England. ",

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T2 - a time series evaluation

AU - Elameer, Mat

AU - Price, Christopher

AU - Flynn, Darren

AU - Rodgers, Helen

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AB - We evaluated the impact of the centralisation of three acute stroke units into a single hyperacute stroke unit within a large urban and rural NHS trust in North East England in June 2015. We performed retrospective interrupted time series analyses of 4,305 stroke patients admitted between 1 April 2013 and 31 December 2017 utilising data recorded for the Sentinel Stroke National Audit Programme. Centralisation was associated with reductions in total length of inpatient stay (–4.9 days [95% CI: –8.1 to –1.7]). Time from admission to thrombolysis shortened by 26.0 minutes (95% CI: –40.0 to –12.1), and time from admission to brain imaging for thrombolysed patients improved by 16.2 minutes (95% CI: –22.0 to –10.4). Time from stroke onset to hospital admission, mortality and dependency (as measured by median modified Rankin Scale) were unaffected by centralisation. This study provides further evidence to support the centralisation of acute stroke services in England.

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The impact of acute stroke service centralisation: a time series evaluation

Abstract

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