James A Swartz, Qiao Lin, Yerim Kim
A measurement invariance analysis of selected Opioid Overdose Knowledge Scale (OOKS) items among bystanders and first responders
PloS one
adherence oral anticoagulants oacs per guideline recommendations crucial reducing ischemic stroke systemic thromboembolism highrisk patients ischemic stroke atrial fibrillation however data oac use underreported china assess adherence chinese stroke association american heart associationamerican stroke associations clinical management guidelinerecommended prescription oacs temporal improvement adherence risk factors associated oac prescriptions quality improvement study conducted 1430 participating hospitals chinese stroke center alliance csca among patients ischemic stroke atrial fibrillation enrolled csca august 1 2015 july 31 2019 calendar year adherence chinese stroke association american heart associationamerican stroke associations clinical management guidelinerecommended prescribing oacs warfarin nonvitamin k oacs including dabigatran rivaroxaban apixaban edoxaban discharge among 35 767 patients 18 785 women 525 mean sd age 755 92 years previous atrial fibrillation admission median cha2ds2vasc cardiac failure dysfunction hypertension age 6574 1 point 75 years 2 points diabetes stroke transient ischemic attack thromboembolism 2 pointsvascular disease sex category female score 40 interquartile range 3050 6303 176 taking oacs prior hospitalization stroke rate increased 143 20 140 third quarter 2015 211 118 560 third quarter 2019 p 001 trend 49 531 eligible patients 26 028 men 525 mean sd age 734 104 years 20 390 412 oac prescription discharge increase 232 36 155 third quarter 2015 471 403 856 third quarter 2019 p 001 trend warfarin commonly prescribed oac 11 956 242 largest temporal increase 58 9 155 207 177 856 older age adjusted odds ratio aor per 5 year increase 08995 ci 089090 lower levels education aor elementary school 084 95 ci 074095 lower income aor 1000 154 066 95 ci 059073 new rural cooperative medical scheme insurance aor 092 95 ci 087096 prior antiplatelet use aor 070 95 ci 066074 several cardiovascular comorbid conditions including stroke transient ischemic attack aor 078 95 ci 075082 hypertension aor 084 95 ci 080089 diabetes aor 091 95 ci 083099 dyslipidemia aor 087 95 ci 080094 carotid stenosis aor 083 95 ci 069098 peripheral vascular disease aor 080 95 ci 071090 admission secondary hospitals aor 071 95 ci 068074 hospitals located central region china aor 080 95 ci 075084 associated prescribed oac discharge quality improvement study suggests despite significant improvement time oac prescriptions remained low efforts increase oac prescriptions especially nonvitamin k oacs needed vulnerable subgroups age socioeconomic status presence comorbid conditions