Improving Stroke Care in Greece in Terms of Management, Costs and Health Outcomes-

Study Overview
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Brief Summary
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The main objectives of the proposed project are: To provide essential data on acute stroke management (quality indicators) incorporating hard clinical outcomes that will contribute to an ongoing process of quality improvement To develop an interactive multichannel platform, for collecting, cleansing and curating high quality in-hospital and follow up data, applying multidimensional quality assessment analysis, providing statistical and analytic reports, monitoring behavioral changes and supporting overall project's management. To evaluate patients' and physicians' experiences and their impact on stroke management. To assess severe negative impact of stroke on the life of survivors including quality of life and disability To measure health related and non- health (loss of productivity, informal care) related national expenditure for stroke care using a bottom up approach To evaluate the value of care focusing on health outcomes compared with total costs of achieving them

Detailed Description
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A prospective cohort multicenter study of patients with first ever acute stroke, hemorrhagic and ischemic, (ICD-10 codes: I61, I63 and I64) admitted within 48 hours of symptoms onset to seven NHS and University hospitals will be conducted. About 1,000 patients (2% of all new cases/annually) will be recruited from six urban and semi-urban areas with 5.5 mil people (50% of Greek population), reporting 25,000 discharged stroke cases annually (53% of all stroke discharges), according to data derived from Hellenic Statistical Authority. All patients will be followed for three months. Moreover, a sub-group of the 300 firstly recruited patients will be followed for a year to obtain data on post hospital health and social needs, health services utilization (medication, rehabilitation, outpatient visits) and productivity loss . Patient enrolment and follow up is estimated to last 18 months.

Official Title
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Improving Stroke Care in Greece in Terms of Management, Costs and Health Outcomes- Stroke Units Necessity for Patients (SUN4P)

Conditions
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Cerebrovascular Disorders

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of hemorrhagic or ischemic stroke (ICD-10: I61, I63 and I64) Patients with First ever acute stroke

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality | Patient based stroke (inpatient and outpatient) mortality | Through hospitalization completion, an average of 10 days | 
| Mortality | Patient based stroke (inpatient and outpatient) mortality | One month | 
| Mortality | Patient based stroke (inpatient and outpatient) mortality | Three months | 
| Modified Rankin Scale (mRS) score | mRS measures the degree of disability or dependence in the daily activities of patients after a stroke or other causes of neurological disability (0: no symptoms at all - 6: Dead) | Through hospitalization completion, an average of 10 days | 
| Modified Rankin Scale (mRS) score | mRS measures the degree of disability or dependence in the daily activities of patients after a stroke or other causes of neurological disability (0: no symptoms at all - 6: Dead) | One month | 
| Modified Rankin Scale (mRS) score | mRS measures the degree of disability or dependence in the daily activities of patients after a stroke or other causes of neurological disability (0: no symptoms at all - 6: Dead) | Three months | 
| National Institutes of Health Stroke Scale (NIHSS) score | NIHSS is a method for assessing the severity of a stroke experienced by a patient (0: No Stroke Symptoms, 42:Severe Stroke) | Through hospitalization completion, an average of 10 days | 
| National Institutes of Health Stroke Scale (NIHSS) score | NIHSS is a method for assessing the severity of a stroke experienced by a patient (0: No Stroke Symptoms, 42: Severe Stroke) | One month | 
| National Institutes of Health Stroke Scale (NIHSS) score | NIHSS is a method for assessing the severity of a stroke experienced by a patient (0: No Stroke Symptoms, 42: Severe Stroke) | Three months | 
| Cost | Average cost per patient | Through hospitalization completion, an average of 10 days | 
| Cost | Average cost per patient | One month | 
| Cost | Average cost per patient | Three months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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stroke, stroke care, stroke units, value of stroke care