Evaluation of clinical pathway in acute ischemic stroke: A comparative study

Abstract Introduction Stroke is the leading cause of death and disability in Chinese adults and brings huge economic burden to the country. Clinical pathways (CP) have been shown to improve outcomes and reduce hospitalization costs and length of stay (LOS) for stroke patients. The objective of this study was to evaluate whether integrating Chinese medicine and western medicine into a clinical pathway for stroke could affect length of stay, hospitalization costs and clinical efficacy. Method This multicenter study consisted of a prospective clinical (CP) and a retrospective clinical study (RCP). Participants in the CP group accepted Chinese medicine and western medicine treatments based on a standard CP protocol while the subjects in RCP group had been offered routine treatment based on the doctorsu0027 personal experience. The information from participants in RCP group was retrospectively collected from the electronic medical system including the demographic characteristics, medical history, neurological impairment evaluation, LOS, hospitalization cost, and critical evidence-based processes in both western medicine and Chinese Medicine. The prospective study was conducted between 18th January to 30th, August, 2010 and the data collection on RCP participants were carried out at the same time. The primary outcome measure was LOS while hospitalization cost, clinical efficacy, adherence of critical processes and incidence of complications were secondary outcome measures. Results LOS in CP and RCP group was 17.2 days and 21.4 days ( P P P Conclusion A clinical pathway for ischemic stroke based on the integration of Chinese medicine and western medicine was effective in shortening LOS, reducing hospitalization cost, improving clinical outcomes and elevating adherence to evidence-based critical processes.