Professor Zhu Yicheng's team "The Lancet" sub-journal revealed: China's 2019-2020 AIS intravenous thrombolysis rate was 5.64%, and the endovascular treatment rate was 1.45%

In recent years, stroke has become the first cause of death and disability in China, and it is a major chronic non-communicable disease that seriously endangers the health of the Chinese people
.

Intravenous thrombolysis and endovascular therapy are the most effective treatments for acute ischaemic stroke (AIS)
.

The Office of the Brain Prevention Committee of the National Health and Health Commission, in conjunction with the team of Professor Zhu Yicheng of Peking Union Medical College Hospital, conducted an in-depth analysis based on the data directly reported by stroke centers of more than 1,700 second-level and above hospitals on the China Cerebrovascular Disease Big Data Platform
.

Recently, the results of the analysis of the current status of intravenous thrombolysis and endovascular treatment of AIS in China by the Office of the National Health and Health Commission's Brain Prevention Committee and the team of Professor Zhu Yicheng of Peking Union Medical College Hospital were published in The Lancet Regional Health - "The Lancet Regional Health - Western Pacific
.

Research Introduction According to a survey conducted by the National Health Commission's Medical Administration and Hospital Administration in general hospitals at level two and above across the country, in 2010, only 0.
38% of AIS patients in China received intravenous thrombolytic therapy, and the proportion who received endovascular therapy was only 0.
38%.
lower
.

In contrast, the thrombolytic rate of AIS in the United States during the same period was about 5.
4%
.

The rate of intravenous thrombolysis and endovascular treatment of AIS patients in China is much lower than that in developed countries
.

In order to promote the sustainable development of stroke prevention and treatment in China, the National Health and Health Commission's Brain Prevention Committee launched the construction of China's stroke center in 2012.
According to the development of intravenous thrombolysis and endovascular treatment of AIS in China, the construction of stroke center units is regularly reviewed.
Conduct on-site guidance and evaluation, formulate standardized AIS treatment procedures and diagnosis and treatment specifications, carry out multi-level training on key appropriate stroke techniques, promote the construction of stroke emergency maps and stroke green channels, and continue to provide stroke center intravenous thrombolysis and endovascular treatment.
Carry out quality control management
.

The leaders of stroke center hospitals at all levels attach great importance to the construction of stroke centers, integrating neurology, neurosurgery, neurointerventional, emergency, critical care, imaging, rehabilitation and other disciplines.
Stroke patients carry out high-quality, full-process, standardized diagnosis and treatment and management
.

A group of interdisciplinary and standardized interdisciplinary talent teams in the field of AIS intravenous thrombolysis/endovascular therapy have promoted and widely applied AIS reperfusion therapy technology to stroke centers at all levels
.

After the continuous promotion of the above work, the intravenous thrombolysis and endovascular treatment capabilities of AIS in China have been effectively improved, which has promoted the continuous improvement of the level of AIS prevention and treatment in China, and ultimately contributed to the realization of the construction goal of "Healthy China 2030"
.

In 2021, the Office of the Brain Prevention Committee of the National Health and Health Commission and the team of Professor Zhu Yicheng of Peking Union Medical College Hospital conducted an in-depth analysis based on the direct reporting data of more than 1,700 stroke centers in secondary and above hospitals on the China Cerebrovascular Disease Big Data Platform.
The results show that China's 2019 -In 2020, the intravenous thrombolysis rate of AIS was 5.
64%, and the endovascular treatment rate was 1.
45%, which provided a reference for understanding the treatment status of cerebrovascular disease in China
.

The analysis covered stroke centers in 31 provinces (autonomous regions and municipalities) in China, including 938 tertiary hospitals and 786 secondary hospitals, which continued to report AIS diagnosis and treatment data from 2019 to 2020
.

The analysis results of the main research results show that: from 2019 to 2020, the overall AIS intravenous thrombolysis rate in stroke centers in China was 5.
64%, and the endovascular treatment rate was 1.
45% (as shown in the figure below), which were significantly improved compared with the past; The median Door to Needle Time (DNT) was 45 minutes, and the median Door to Puncture Time (DPT) was 106 minutes, which were significantly shorter than before
.

The stratified analysis of hospitals showed that the intravenous thrombolysis rate in secondary hospitals was significantly higher than that in tertiary hospitals (6.
39% vs.
5.
39%), while the endovascular treatment rate in tertiary hospitals was significantly higher than that in secondary hospitals (1.
84% vs.
.
0.
29%)
.

The analysis also revealed differences in the treatment characteristics of different tiers of hospitals, for example: tertiary hospitals had shorter DNT than secondary hospitals, but longer Onset to Needle Time (ONT); similarly, tertiary hospitals Hospitals have shorter DPT than secondary hospitals, but longer Onset to Puncture Time (OPT); tertiary hospitals use recombinant tissue type plasminogen activator (recombinant tissue type plasminogen activator) than secondary hospitals , rt-PA) with a higher proportion of thrombolysis, while a higher proportion of urokinase thrombolysis was used in secondary hospitals; a higher proportion of stent thrombectomy was used in tertiary hospitals than in secondary hospitals, while intra-arterial thrombolysis was used in secondary hospitals ratio is higher
.

The picture shows the rate of intravenous thrombolysis and endovascular treatment of AIS in China from 2019 to 2020
.

(Quoted from Ye Q, et al.
Lancet Reg Health West Pac.
2022) Conclusion The results of this analysis suggest that: In recent years, the rate of intravenous thrombolysis and endovascular treatment of AIS in China has been significantly improved
.

The construction of stroke center network, stroke emergency map and stroke green channel promoted by the National Health and Health Commission's Brain Prevention Committee has significantly shortened the pre-hospital and in-hospital time of AIS emergency treatment, and improved the quantity and quality of AIS reperfusion treatment
.

The stroke data direct reporting platform established by the National Health Commission's Brain Prevention Committee provides an important reference for dynamically tracking the development of stroke prevention and treatment in China
.

In addition, the differences in the characteristics of intravenous thrombolysis and endovascular treatment in hospitals at different levels in China highlight the importance of strengthening the construction of a regional stroke prevention and control network.
Platforms such as multi-disciplinary teams and regional medical consortia have closely cooperated with the emergency system and other medical consortium units in the region to establish an efficient regional stroke treatment network.
By leveraging its own technical advantages, it has gradually formed a set of complete organizational structure and technical Standardized procedures, scientific quality control management, and a stroke center organization and management system with Chinese characteristics
.

Source: "China Heart and Brain Health" public account