[Analysis of the improvement effect of Jilin Province Stroke Emergency Map initiative on the efficiency of emergency care for acute ischemic stroke].
Zhonghua yi xue za zhi · 2025-12-23 · Quasi-experimental
Abstract
Objective: To assess the impact of the Jilin Province Stroke Emergency Map (JSEM) initiative on the efficiency of emergency care for acute ischemic stroke. Methods: This study utilized data from the Jilin Stroke Center Construction Management Information System to describe the contruction of the regional stroke emergency network in Jilin Province since the JSEM initiative launched. Comparisons were made regarding the number and proportion of acute ischemic stroke patients receiving intravenous thrombolysis (IVT) and mechanical thrombectomy (MT), as well as the Emergency Medical Services (EMS) response times, during the following periods: the 1-year pre-JSEM period (August 2016-July 2017), and the 1-year periods following the release of JSEM Version 1 (August 2017-July 2018), Version 2 (August 2018-July 2019), Version 4 (December 2021-November 2022), and Version 5 (August 2023-July 2024). Results: As JSEM evolved from Version 1 (August 2017) to Version 6 (September 2024), the number of hospitals in Jilin Province with IVT capability increased from 19 to 71, and those with MT capability increased from 10 to 30. With the increase in IVT-capable hospitals within the JSEM network, the number of acute ischemic stroke patients receiving IVT in Jilin Province has increased continuously, from 2 585 cases in the year pre-Version 1 to 9 464 cases within the year following Version 5 release. The IVT rate among the patients entering the"green channel"of stroke also increased from 3.3% (2 585/78 063)to 5.5%(9 464/172 951). The median door-to-needle time decreased from 62 (54, 71) minutes pre-Version 1 to 51 (43, 60) minutes post-Version 5. Meanwhile, the number of patients receiving emergency MT in Jilin Province rose from 457 cases pre-Version 1 to 1 337 cases post-Version 5; the MT rate among patients entering the"green channel"of stroke increased from 0.6% (457/78 063) to 0.8% (1 337/172 951). Treatment timeliness for MT also improved: the door-to-puncture time shortened from 136 (104, 157) minutes pre-Version 1 to 112 (94, 143) minutes post-Version 5. Conclusions: The launch and promotion of JSEM effectively reduces stroke-induced death and disability rates by optimizing the provincial stroke emergency network, reducing pre-and post admission delays, and enhancing treatment efficiency, which contributes to achieving the goals of the national"One Million Disability Reduction Project".
Tags
Antithrombotics & thrombolytics · Implementation · Thrombolytics · Time intervals