Outcomes of Stroke Fast Track Services for the Treatment of Acute Ischemic Stroke in Chaiyaphum Hospital - ผลการรักษาผู้ป่วยเส้นเลือดสมองอุดตันเฉียบพลัน ในโรงพยาบาลชัยภูมิ โดยใช้ระบบทางด่วนพิเศษ

Abstract

The objective of this study was to assess the outcomes of fast track medical services for patients
with acute ischemic stroke attending the Department of Medicine, Chaiyaphum Hospital during January
to December 2013. The study was conducted in 4 phases which included (1) screening of stroke
patients for the enrolment into the fast track services, (2) providing rapid assessment and treatment,
(3) evaluation of treatment outcomes, and (4) collecting and analyzing data to compare the results with
the group of patients who received routine services, as well as to compare with the similar studies
conducted elsewhere both domestically and abroad. It was found that there were 1,461 cases of acute
stroke during the study period. Among them 1,095 were acute ischemic in nature, of whom 37 cases
were enrolled into the fast track service. All the patients in the fast track got thrombolytic agent and
were admitted in the intensive care unit or a general ward which designed as the stroke corner. Their
treatment outcomes were monitored using the U.S. National Institutes of Health Stroke Scale, admission
duration and death rate. We found that patients receiving stroke fast track services had NIHSS score
decreased from 9.9 to 5.3, admission duration of 4.2 days and the death rate of 2.7%. Comparing with
the patients receiving routing stroke care services using Fisher exact test, the death rates of both groups
were not significant different. Further study was recommended to collect bigger sample size for the fast
track services to differentiate from the routine stroke care. Nevertheless, improvement of treatment
indicators observed in this study suggested that stroke fast track should be a favorable option to improve
treatment outcomes for stroke patients.
Key words: stroke fast track, acute ischemic stroke, stroke corner, thrombolytic agent