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Case characteristics, hyperacute treatment, and outcome information from the clinical research center for stroke-fifth division registry in South Korea.

Kim BJ, Park JM, Kang K, Lee SJ, Ko Y, Kim JG, Cha JK, Kim DH, Nah HW, Han MK, Park TH, Park SS, Lee KB, Lee J, Hong KS, Cho YJ, Lee BC, Yu KH, Oh MS, Kim DE, Ryu WS, Cho KH, Kim JT, Choi JC, Kim WJ, Shin DI, Yeo MJ, Sohn SI, Hong JH, Lee J, Lee JS, Yoon BW, Bae HJ - J Stroke (2015)

Bottom Line: The rate of symptomatic hemorrhagic transformation (HT) was 7%, and that of any HT was 27% among recanalization-treated cases.Early neurological deterioration occurred in 15% of cases and were associated with longer length of stay and poorer 3-month outcomes.The above findings will be compared with other Asian and US registry data in this article.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.

ABSTRACT
Characteristics of stroke cases, acute stroke care, and outcomes after stroke differ according to geographical and cultural background. To provide epidemiological and clinical data on stroke care in South Korea, we analyzed a prospective multicenter clinical stroke registry, the Clinical Research Center for Stroke-Fifth Division (CRCS-5). Patients were 58% male with a mean age of 67.2±12.9 years and median National Institutes of Health Stroke Scale score of 3 [1-8] points. Over the 6 years of operation, temporal trends were documented including increasing utilization of recanalization treatment with shorter onset-to-arrival delay and decremental length of stay. Acute recanalization treatment was performed in 12.7% of cases with endovascular treatment utilized in 36%, but the proportion of endovascular recanalization varied across centers. Door-to-IV alteplase delay had a median of 45 [33-68] min. The rate of symptomatic hemorrhagic transformation (HT) was 7%, and that of any HT was 27% among recanalization-treated cases. Early neurological deterioration occurred in 15% of cases and were associated with longer length of stay and poorer 3-month outcomes. The proportion of mRS scores of 0-1 was 42% on discharge, 50% at 3 months, and 55% at 1 year after the index stroke. Recurrent stroke up to 1 year occurred in 4.5% of patients; the rate was higher among older individuals and those with neurologically severe deficits. The above findings will be compared with other Asian and US registry data in this article.

No MeSH data available.


Related in: MedlinePlus

Timeline of the CRCS-5 registry. DB, database. QI, quality indicator.
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Figure 2: Timeline of the CRCS-5 registry. DB, database. QI, quality indicator.

Mentions: The database tables of the CRCS-5 registry have expanded since its initiation. The initial KSR database included demographic information locations and parenchymal lesions, arterial occlusion, stroke mechanism, National Institute of Health Stroke Scale (NIHSS) score at arrival, laboratory values, and treatment information. The CRCS-5 registry maintained the structure of the KSR database as "initial and extended tables" with some minor modifications. In October 2008, a clinical practice-monitoring database table was introduced for quality improvement of stroke care. In November 2009, the CRCS-5 registry set up a new database table dedicated to hyperacute treatment and acute management information. The CRCS-5 registry steering committee has long been in need of prospective stroke outcomes, and thus it implemented a systematic capture strategy for prospective outcomes, including functional status and vascular events in November 2009, selecting five centers with sufficient resources (Eulji General Hospital, Seoul National University Bundang Hospital, Seoul Medical Center, Soonchunhyang University Hospital Seoul, and Inje University Ilsan Paik Hospital). With a piloting operation duration of 14 months, the prospective outcome capture strategy was expanded to all participating CRCS-5 registry centers in January 2011. Prospective outcome information included functional and event outcomes at 3 months and 1 year after stroke onset as well as early neurological deterioration (END; details will be discussed later). Further, temporary database tables were set up for any specific research purposes (Figure 2).


Case characteristics, hyperacute treatment, and outcome information from the clinical research center for stroke-fifth division registry in South Korea.

Kim BJ, Park JM, Kang K, Lee SJ, Ko Y, Kim JG, Cha JK, Kim DH, Nah HW, Han MK, Park TH, Park SS, Lee KB, Lee J, Hong KS, Cho YJ, Lee BC, Yu KH, Oh MS, Kim DE, Ryu WS, Cho KH, Kim JT, Choi JC, Kim WJ, Shin DI, Yeo MJ, Sohn SI, Hong JH, Lee J, Lee JS, Yoon BW, Bae HJ - J Stroke (2015)

Timeline of the CRCS-5 registry. DB, database. QI, quality indicator.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325643&req=5

Figure 2: Timeline of the CRCS-5 registry. DB, database. QI, quality indicator.
Mentions: The database tables of the CRCS-5 registry have expanded since its initiation. The initial KSR database included demographic information locations and parenchymal lesions, arterial occlusion, stroke mechanism, National Institute of Health Stroke Scale (NIHSS) score at arrival, laboratory values, and treatment information. The CRCS-5 registry maintained the structure of the KSR database as "initial and extended tables" with some minor modifications. In October 2008, a clinical practice-monitoring database table was introduced for quality improvement of stroke care. In November 2009, the CRCS-5 registry set up a new database table dedicated to hyperacute treatment and acute management information. The CRCS-5 registry steering committee has long been in need of prospective stroke outcomes, and thus it implemented a systematic capture strategy for prospective outcomes, including functional status and vascular events in November 2009, selecting five centers with sufficient resources (Eulji General Hospital, Seoul National University Bundang Hospital, Seoul Medical Center, Soonchunhyang University Hospital Seoul, and Inje University Ilsan Paik Hospital). With a piloting operation duration of 14 months, the prospective outcome capture strategy was expanded to all participating CRCS-5 registry centers in January 2011. Prospective outcome information included functional and event outcomes at 3 months and 1 year after stroke onset as well as early neurological deterioration (END; details will be discussed later). Further, temporary database tables were set up for any specific research purposes (Figure 2).

Bottom Line: The rate of symptomatic hemorrhagic transformation (HT) was 7%, and that of any HT was 27% among recanalization-treated cases.Early neurological deterioration occurred in 15% of cases and were associated with longer length of stay and poorer 3-month outcomes.The above findings will be compared with other Asian and US registry data in this article.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.

ABSTRACT
Characteristics of stroke cases, acute stroke care, and outcomes after stroke differ according to geographical and cultural background. To provide epidemiological and clinical data on stroke care in South Korea, we analyzed a prospective multicenter clinical stroke registry, the Clinical Research Center for Stroke-Fifth Division (CRCS-5). Patients were 58% male with a mean age of 67.2±12.9 years and median National Institutes of Health Stroke Scale score of 3 [1-8] points. Over the 6 years of operation, temporal trends were documented including increasing utilization of recanalization treatment with shorter onset-to-arrival delay and decremental length of stay. Acute recanalization treatment was performed in 12.7% of cases with endovascular treatment utilized in 36%, but the proportion of endovascular recanalization varied across centers. Door-to-IV alteplase delay had a median of 45 [33-68] min. The rate of symptomatic hemorrhagic transformation (HT) was 7%, and that of any HT was 27% among recanalization-treated cases. Early neurological deterioration occurred in 15% of cases and were associated with longer length of stay and poorer 3-month outcomes. The proportion of mRS scores of 0-1 was 42% on discharge, 50% at 3 months, and 55% at 1 year after the index stroke. Recurrent stroke up to 1 year occurred in 4.5% of patients; the rate was higher among older individuals and those with neurologically severe deficits. The above findings will be compared with other Asian and US registry data in this article.

No MeSH data available.


Related in: MedlinePlus