| Objective1. Scientometrics techniques were used to analyze research literatures about stroke emergency treatment, to characterize the hot themes and knowledge structure, to identify the core journals, authors as well as research teams playing major roles, in order to provide valuable information for policy makers, librarians, scientific researchers and clinical workers.2. Stroke patients'knowledge, attitude and practice (KAP) about stroke and satisfaction with treatment were surveyed, to provide basic data for the management of stroke treatment.Methods1. Scientometrical analysisA total of 4749 articles about stroke emergency treatment were retrieved from Web of Science, and the keywords, journal, public year and authors of each article were extracted with the software Biblexcel. Combined with the concepts and tools of social network analysis, co-word analysis, Bradford's journals distribution and co-authorship network were conducted for quantitive analysis of the scientific research in the field of stroke emergency treatment.2. Field investigationThe questionnaire was designed based on the results of a focus group discussion. A face-to-face survey was conducted among stroke patients or their families in multiple tertiary general hospitals, to collect patients'basic information, KAP about stroke and satisfaction with treatment. A total of 778 valid questionnaires were received. The database was established with the software EpiData 3.02, and data collation and analysis were processed by Excel and SPSS 18.0. Results and Conclusions1. The field of stroke emergency treatment has basically completed systematic and organized process and entered into a normal period.After the discovery of tPA for early treatment of ischemic stroke, the field of stroke emergency treatment has seen an increase of scientific research, the emergence of core scientists, research teams, professional academic organizations, professional core journals and updated promptly guidelines of stroke management, and the recognition and application of stroke unit in clinical practice. In a word, the field has been in a systematic and organized normal period. However, sound theoretical and practical system has not been formed in this field, and the time delay is still a bottleneck restricting the development.2. Research on stroke emergency treatment has a more broader perspective and in-depth and specific research topics.Co-word analysis shows that the perspective of research on stroke emergency treatment has gradually turned from focusing on cure to combining prevention and treatment, and that the scope of the study ranges from primary prevention to treatment and prognosis, including all pre-hospital and in-hospital processes. And now the hot research topics are ischemic stroke treatment with tPA and its time window and delay, stroke awareness and health education, stroke subtypes and stroke registry, etc.3. Core journals have a larger number of papers and greater academic influence.The number of core journals of this field is about 10 in recent years, such as STROKE, CEREBROVASCULAR DISEASES, JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, NEUROCRITICAL CARE, EUROPEAN JOURNAL OF NEUROLOGY, NEUROLOGY, NEUROSURGERY, JOURNAL OF NEUROLOGY and JOURNAL OF THE NEUROLOGICAL SCIENCES. They have published a larger number of papers, and received greater scientific reputation within the field of stroke emergency treatment.4. Research collaboration is increasingly extensive and intensive, the flow of knowledge and information speeds up.In the past 16 years, there have been a growth trend in collaborative publication outputs and the number of collaborators of an author. Research cooperation have shifted from the national inter-institutional, inter-specialty to the multiple institutions, different specialties, and even international cooperation.The largest component contains about 80% of all authors in this field, and the sub-network is a small world network. In the context of today's international cooperation, any two researchers in the field will be able to establish contact through an average of six middlemen. These features indicate that the communication among the researchers in the field are extensive, and facilitates knowledge and information flow inside the field, In other words, the new theories, methods and techniques could quickly spread.5. Stroke emergency treatment has encountered the bottleneck of time delay, which is caused mainly by the poor stroke awareness of the whole society.When stroke symptom onset, only 37.2% of patients recognized they were having a stroke,42.32% of patients decided to go to the hospital immediately, patients contacting EMS immediately accounted for 15.36%, and nearly half of patients failed to arrive hospital within 2 hours of stroke onset. These results suggest that delayed presentation after stroke symptom onset is still significant in our country, and the main causes are the poor recognition of stroke symptoms and the lack of awareness to seek medical help rapidly.A large percent of patients did not satisfy with the stroke knowledge provided by the medical care providers. This suggests that the medical care providers may fail to regard stroke treatment as a systematic work, and to ignore the importance of secondary prevention, so could not meet the patients'needs for stroke knowledge.6. Stroke emergency treatment among rural residents is a most serious issue.The rural residents made a decision to seek medical treatment for a longer time, and lived farther away from the hospitals that provide emergency stroke care. They could not timely receive effective stroke treatment due to the constraints of economy, transport and information. 7. The emergency medical system (EMS) needs to be improved.Taxi is the most transportation by which the patients arrived at hospital (33.77%), followed by ambulance (29.74%) and private car (16.36%), and the average speed of the ambulance was slower than that of the other two (p<0.005). This indicates that the EMS in our country is still backward, and can not satisfy the needs of the public.Suggestions1. Academic exchanges and cooperation should be enhanced, to further promote the information dissemination and the conversion of the knowledge and technology.2. It is essential to improve stroke education for the public, especially in rural areas, and to highlight professional education to promote awareness of the updated theory, methods and techniques on stroke treatment.3. The responsibility system for health education should be implemented within hospital.4. Telemedicine can be applied to provide stroke treatment for patients located in rural areas.5. The EMS system should be improved, and strengthen its social influence.Innovations1. It is the first time to apply the principles and methods of scientometrics to explore the scientific research of stroke emergency treatment.2. The issue of stroke emergency treatment is firstly expanded from a simple model of disease prevention and control to a systematic model, in which the practice is guided by and feeds back to the scientific research. |
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