Multicentre collection of uniform data on patients hospitalised for transient ischaemic attack or stroke in the Philippines: the Philippine Neurological Association One Database-Stroke (PNA1DB-Stroke) protocol

Philippine Neurological Association One Database - Stroke, Disease Study Management Group, Robert N Gan, Raquel M Alvarez, Maria Teresa Cañete, Christian Oliver Co, Maria Epifania Collantes, Cyrus G Escabillas, John Harold Hiyadan, Dan Neftalie Juangco, Johnny K Lokin, Maria Cristina Macrohon-Valdez, Monique Therese Punsalan, Gemmalynn B Sarapuddin, Rosalina E Picar, Jose Leonard R Pascual V, Philippine Neurological Association One Database - Stroke, Disease Study Management Group, Robert N Gan, Raquel M Alvarez, Maria Teresa Cañete, Christian Oliver Co, Maria Epifania Collantes, Cyrus G Escabillas, John Harold Hiyadan, Dan Neftalie Juangco, Johnny K Lokin, Maria Cristina Macrohon-Valdez, Monique Therese Punsalan, Gemmalynn B Sarapuddin, Rosalina E Picar, Jose Leonard R Pascual V

Abstract

Introduction: For scientific advances to translate into improved patient outcomes, systems of care must be in place to facilitate delivery of care. There is scarce information on quality of care and clinical outcome in our stroke patients. We aim to collect uniform data from patients with first or recurrent transient ischaemic attack (TIA) or ischaemic or haemorrhagic stroke to determine in-patient caseload, patient profile, types of diagnostic and therapeutic procedures, outcomes and overall quality of care among patients hospitalised for acute stroke in the Philippines.

Methods and analysis: This multicentre observational study and standing database will include patients diagnosed with first or recurrent TIA, ischaemic or haemorrhagic stroke or cerebral venous thrombosis, ≥18 years old, and admitted in any of the country's 11 accredited adult neurology residency training institutions. Anonymised data on sociodemographics, medical history, stroke subtype, in-hospital management and discharge outcomes will be collected and entered in a database using a secure online data platform. Outcomes include in-hospital complications, functional, neurological and vital (alive or dead) status at discharge.We intend to capture data from all TIA and stroke cases in participating sites. Based on 2017-2019 census, approximately 10 000 cases each year may be included. Collective data spanning 3 years will be extracted, summarised and analysed every year.

Ethics and dissemination: Approval from ethics committees or institutional review boards (EC/IRB) was obtained from the Single Joint Research Ethics Board and all participating institutions. As this study involves no more than minimal risk to patients, waiver of informed consent was requested. Written information about the study will be provided to patients or legal representative. If site EC/IRB requires written consent, only approved consent forms will be used.To identify areas of improvement and guide public health policies, data on 'real-world' situation are needed. The Philippine Neurological Association One Database-Stroke initiative may become a model that can be implemented in other designated stroke-ready hospitals.

Trial registration: NCT04972058; ClinicalTrials.gov.

Keywords: Health policy; NEUROLOGY; Protocols & guidelines; Quality in health care; Stroke.

Conflict of interest statement

Competing interests: PNA1DB is a not-for-profit initiative. Committee members, investigators and collaborators may have been involved in previous works wherein potential conflicts of interests were declared within the original publications.

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

References

    1. GBD 2016 Neurology Collaborators . Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the global burden of disease study 2016. Lancet Neurol 2019;18:459–80. 10.1016/S1474-4422(18)30499-X
    1. Navarro JC, Baroque AC, Lokin JK, et al. . The real stroke burden in the Philippines. Int J Stroke 2014;9:640–1. 10.1111/ijs.12287
    1. Adeoye O, Nyström KV, Yavagal DR. Recommendations for the establishment of stroke systems of care: a 2019 update: a policy statement from the American stroke association. Stroke 2019;50:e187–210. 10.1161/STR.0000000000000173
    1. Roxas AA. The RIFASAF project: a case-control study on risk factors for stroke among Filipinos. Philippine J Neurol 2002;6:1–7.
    1. Co COC, Yu JRT, Laxamana LC, et al. . Intravenous thrombolysis for stroke in a COVID-19 positive Filipino patient, a case report. J Clin Neurosci 2020;77:234–6. 10.1016/j.jocn.2020.05.006
    1. Laxamana LC, Co COC, Yu JRT, et al. . Dabigatran reversal with Idarucizumab preceding thrombolysis in an octogenarian patient with chronic kidney disease and acute stroke: a case report. Clin Ther 2020;42:1840–5. 10.1016/j.clinthera.2020.07.006
    1. Co COC, Yu JRT, Macrohon-Valdez MC, et al. . Acute stroke care algorithm in a private tertiary hospital in the Philippines during the COVID-19 pandemic: a third World country experience. J Stroke Cerebrovasc Dis 2020;29:105059. 10.1016/j.jstrokecerebrovasdis.2020.105059
    1. Jamora RDG, Kishi-Generao EM, Bitanga ES, et al. . The ICH score: predicting mortality and functional outcome in an Asian population. Stroke 2003;34:6–7. 10.1161/01.STR.0000047847.18178.D3
    1. Yu RF, San Jose MCZ, Manzanilla BM, et al. . Sources and reasons for delays in the care of acute stroke patients. J Neurol Sci 2002;199:49–54. 10.1016/s0022-510x(02)00103-x
    1. Navarrro JC, Escabillas C, Aquino A, et al. . Stroke units in the Philippines: an observational study. Int J Stroke 2021;16:1747493020981730:849–54. 10.1177/1747493020981730
    1. Jamora RDG, Corral EV, Ang MA, et al. . Stroke recurrence among Filipino patients taking aspirin for first‐ever non‐cardioembolic ischemic stroke. Neurol Clin Neurosci 2017;5:113–7. 10.1111/ncn3.12133
    1. Veerbeek JM, Kwakkel G, van Wegen EEH, et al. . Early prediction of outcome of activities of daily living after stroke: a systematic review. Stroke 2011;42:1482–8. 10.1161/STROKEAHA.110.604090
    1. Lichtman JH, Leifheit-Limson EC, Jones SB, et al. . Predictors of hospital readmission after stroke: a systematic review. Stroke 2010;41:2525–33. 10.1161/STROKEAHA.110.599159
    1. E6(R2) Good Clinical Practice: Integrated Addendum to ICH E6 (R1) Guidance for Industry. Available: [Accessed 24 Jun 2021].
    1. Philippine Health Research Ethics Board . National ethical guidelines for health and health-related research 2017 (version 2). Department of science and technology, Philippine Council for health research and development. Philippines, 2018.
    1. Understanding the eCFR. Available: [Accessed 24 Jun 2021].
    1. Roxas AA. The stroke Society of the Philippines Handbook of stroke. guidelines for prevention, treatment and rehabilitation. 6th ed. Philippines: GoldenPages Publishing Company, 2014.
    1. Kernan WN, Ovbiagele B, Black HR, et al. . Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American heart Association/American stroke association. Stroke 2014;45:2160–236. 10.1161/STR.0000000000000024
    1. Powers WJ, Rabinstein AA, Ackerson T, et al. . 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American heart Association/American stroke association. Stroke 2018;49:e46–99. 10.1161/STR.0000000000000158
    1. Hemphill JC, Greenberg SM, Anderson CS, et al. . Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American heart Association/American stroke association. Stroke 2015;46:2032–60. 10.1161/STR.0000000000000069
    1. Connolly ES, Rabinstein AA, Carhuapoma JR, et al. . Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American heart Association/american stroke association. Stroke 2012;43:1711–37. 10.1161/STR.0b013e3182587839

Source: PubMed

3
Subscribe