Knowledge Attitudes and Practice about Stroke amongst Neurologists in India

Dulari Gupta, Sreehari Dinesh, S. Narayan, S. Gorthi
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Abstract

Background There is paucity of data regarding knowledge about diagnosis, aetiology, investigations, and management of stroke amongst neurologists in India. Methodology A cross-sectional observational analytical study in which the Knowledge, Attitudes, and Practice about stroke were assessed amongst neurologists across India using a Google Form with 30 multiple-choice questions and 10 case scenarios about acute ischemic stroke, acute hemorrhagic stroke, and cerebral venous sinus thrombosis. This Google Form was circulated amongst all Indian Academy of Neurology groups online from October 2022 to December 2022. Responses were analyzed question wise. Results A total of 148 neurologists responded with 90.5% practicing in urban India. In acute ischemic stroke only 56% chose noncontrast CT brain as the mainstay of imaging in stroke diagnosis. Similarly only 50% said that vascular imaging (CT angiography or MRI angiography) was important in stroke imaging. Questionnaires pertaining to the indications and contraindications for intravenous thrombolysis were well responded. Most answers on intracerebral hemorrhage were correct. Many neurologists are using DOAC in treatment of CVT even though latest studies have hinted towards their safety, but randomized control trials are still underway. Conclusion Results show good knowledge and practice in the field of acute hemorrhagic stroke and moderate results in CVT while there are glaring knowledge gaps in acute ischemic stroke. This reflects the rapidly changing field of acute ischemic stroke. The aim of training programs and conferences should be to update neurologists on this rapidly evolving field.
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印度神经科医生对中风的知识、态度和实践
印度的神经科医生对中风的诊断、病因、调查和管理方面的知识缺乏数据。方法一项横断面观察性分析研究,对印度神经科医生对中风的知识、态度和实践进行评估,使用谷歌表格,其中包含30个多项选择题和10个关于急性缺血性中风、急性出血性中风和脑静脉窦血栓形成的案例。这份谷歌表格于2022年10月至2022年12月在印度神经病学学会的所有在线小组中分发。对回答进行了问题分析。结果148名神经科医生参与调查,其中90.5%在印度城市执业。在急性缺血性脑卒中中,只有56%的患者选择非对比CT作为脑卒中诊断的主要影像学手段。同样,只有50%的人认为血管成像(CT血管成像或MRI血管成像)在卒中成像中很重要。关于静脉溶栓的适应症和禁忌症的问卷调查得到了很好的回应。脑出血的回答多数正确。尽管最新的研究表明DOAC是安全的,但许多神经科医生仍在使用DOAC治疗CVT,但随机对照试验仍在进行中。结论对急性出血性脑卒中有较好的认识和实践,在CVT方面效果一般,而在急性缺血性脑卒中方面存在明显的知识空白。这反映了急性缺血性脑卒中领域的快速变化。培训计划和会议的目的应该是让神经科医生了解这个快速发展的领域。
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