The Evaluation Of Application Effects In The Treatment Of The Clinical Pathways To Acute Cerebral Infarction

Purpose of researchFor better understand the applied value of clinical pathway in acute cerebral infarction treatment,and also for successful implementation of it,health economy parameters and curative effect index are measured to evaluate the application effects based on the theory and method of the experimental epidemiology.Materials and MethodsPatients with acute cerebral infarction in the Changzhou Wujin People's hospital from Jan.1^st,2016 to December 31^st are included.According to clinical diagnosis,the total number of research objects is 240,among which 125 patients are treated by clinical pathway and 115 patients are treated by traditional medical model.Data collection includes demographic information,previous history,associated diseases,laboratory tests,health economics,neurological function evaluation and death records.In order to compare the differences between two research groups in health economy and curative effect,data analysis was performed with SPSS19.0.Results1.There are 119 male patients?49.6%?and 121 female patients?50.4%?among240 included patients.According to Oxford Community Stroke Project?OCSP?,there are 10 patients with Total Anterior Circulation Infarct?TACI??4.17%?,69 patients with Partial Anterior Circulation Infarct?PACI??28.75%?,19 patients with Posterior Circulation Infarct?POCI??7.92%?and 142 patients with Lacunar Cerebral Infarction?LACI??59.16%?.2.Control group has higher prevalence of hypertention and diabetes than pathway group,two groups of patients distribution compared statistically significant difference?P<0.05?.But it has no statistical significance?with P value>0.05?in the distributional difference of pathway group and control group about the subtypes of ages,gender,smoke,drinking and cerebral infarction,NIHSS,dyslipidemia and hyperuricemia.3.The length of hospital stay,expenses and cost of antibiotics of pathway group are lower?with P value<0.05?than those of control group obviously.The differences of the length of stay,inpatients expenses and treatment costs among cerebral infarction types according to OCSP are of statistical significance?with P value>0.05?.The TACI has the longest lengths of stay and highest inpatients expenses,the PACI is second to it,the parameters above of POCI is lower than PACI but a bit higher than LACI.Four cerebral infarction's types have no statistical significance?with P value>0.05?in the differences of test and antibiotics costs.4.The patients with complication?hypertension,diabetes?from the control group have longer?with P value<0.05?length of stay and more treatment expenses than patients with no complication in the same group,and statistical significance is also not existed in pathway group.5.Patients from pathway group with complication of hypertension have longer length of stay and less total medical expenses than control group?with P value<0.05?.Patients from pathway group with complication of diabetes have longer length of stay,less total medical expenses and less antibiotics costs than control group?with P value<0.05?.6.It is of no statistical significance between the groups in the aspects of neurological functional deficit scales,evaluation index of activity of daily living and mortality after one-month treatment?with P value>0.05?;the recovery of neurological impairment of the pathway group is better than the recovery of the comparison group after three-month treatment?with P value<0.05?,it is of no statistical difference between the groups in the aspects of the evaluation of activity of daily living and mortality?with P value>0.05?.ConclusionThe carryout and implementation of clinical pathway of acute cerebral infarction helps us take standardized model to cure this disease and has certain positive effects in the aspects of controlling medical cost,reducing medical expenses,normalizing clinical medication and improving medical quality.However,in the cases of curing patients with complications?hypertension,diabetes?,this pathway have no advantage in shortening the length of hospital stay,even it is effective to control medical expenses.