1) To determine compliance of practice patterns to clinical practice guidelines for acute ischemic stroke patients in Manila Doctors Hospital (MDH) Philippines, a tertiary private hospital in the Philippines, and 2) to determine the effectiveness of the stroke pathway system of the MDH Acute Stroke Unit in reducing time to diagnostics and initiation of treatment for acute ischemic stroke.
This study dealt with chart review of acute ischemic stroke patients before and after the stroke pathway system was instituted in Manila Doctors Hospital (MDH) Philippines last May 2009. It was divided into pre- and post-stroke pathway phases. Data collected and compared for statistical significance were practice patterns, time interval from emergency room consultation to instituting diagnostic and therapeutic interventions, and length of hospitalization.
There was high compliance (94.8 - 100%) to level I guideline recommendations in both phases of the study in many diagnostic examinations and therapeutic interventions. On the other hand, carotid and transcranial doppler utilization significantly increased in phase II which was also seen for citicoline and statin usage. A non-statistically significant improvement in the time lag was noted during phase II.
High compliance rates to many level I guideline recommendations in both diagnostic and therapeutic practice patterns in acute ischemic stroke were seen in MDH. Adherence to the stroke pathway system has probably resulted to increased usage of recommended diagnostic and therapeutic interventions, however, there is a need to improve time interval from emergency room consultation to commencement of diagnostic procedures and delivery of appropriate therapy.