American Heart Association rapid access journal report:
Acute stroke care and clinical outcomes have improved significantly at hospitals participating in the American Heart Association/American Stroke Association’s Get With The Guidelines–Stroke program, according to a large study in Circulation: Cardiovascular Quality and Outcomes, a journal of the American Heart Association.
To better characterize contemporary stroke patients and determine the impact of Get With The Guidelines–Stroke participation, researchers analyzed several aspects of the first 1 million stroke patients at 1,392 hospitals participating in the quality improvement initiative from 2003 to 2009.
Each year more than 795,000 Americans suffer a stroke and another 200,000 to 500,000 present with a transient ischemic attack (TIA), often called a “warning stroke.”
“We found that the opportunities to provide guideline-recommended care addressed by the performance measures were substantially met for stroke and TIA patients, with overall composite care improving substantially from 72 percent in 2003 to 93 percent in 2009,” said Gregg C. Fonarow, M.D., lead author of the study and professor of cardiovascular medicine at the University of California-Los Angeles. “Stroke and TIA patients receiving all of the care measures for which they were eligible increased from 44 percent in 2003 to 84 percent in 2009.”
Patients in the database were an average 70.1 years of age. Of all strokes analyzed, ischemic strokes (caused by a blood clot blocking a blood vessel in the brain) were the most common (60.2 percent), followed by TIAs (22.8 percent), intracerebral hemorrhages (10.9 percent), subarachnoid hemorrhages (3.5 percent) and unclassified strokes (2.7 percent).
In-hospital mortality was highest among patients suffering hemorrhagic strokes (caused by blood leaking into the brain tissue). Hospital participation in Get With The Guidelines–Stroke made the biggest impact on stroke death rates among the most common stroke types – ischemic stroke and TIA – reducing the risk-adjusted odds of in-hospital mortality rate after ischemic stroke by 10 percent.
“The study has shown what is of primary importance to those who rely on the nation’s hospitals for optimal stroke care: the implementation of Get With The Guidelines–Stroke has resulted in substantial improvement in care at a rapid pace in a variety of hospital types and in multiple hospitals, simultaneously,” said Lee H. Schwamm, M.D., study co-author, chair of the Get With The Guidelines National Steering Committee and director of the TeleStroke and Acute Stroke Services at Massachusetts General Hospital in Boston, Mass.
The initiative is making a landmark contribution to stroke patients of today and tomorrow, said Clyde W. Yancy, M.D., president of the American Heart Association.
“Not only has quality improved, but lives are being saved and subsequent strokes are being thwarted,” said Yancy, medical director at the Baylor Heart and Vascular Institute in Dallas. “These findings demonstrate the true potential of implementing best practices within a care delivery system and the approach taken by the Get With The Guidelines team is a template for the future.” To facilitate better treatment and outcomes for stroke patients, the American Heart Association/American Stroke Association has launched Target: Stroke. The program will arm healthcare providers with information and tools to improve the use of the intravenous thrombolysis recombinent tissue plasminogen activator (IV rt-PA), the only drug approved by the U.S. Food and Drug Administration for the urgent treatment of ischemic stroke.
“An earlier analysis of Get With The Guidelines–Stroke data found that despite clinical trial evidence of improved outcomes for stroke patients treated early with an intravenous clot buster, only 27.4 percent of patients treated with IV rt-PA had door-to-needle times within 60 minutes,” Yancy said. “The goal for Target: Stroke is to achieve a door-to-needle time within 60 minutes or less in at least 50 percent of ischemic stroke patients treated with a clot-busting drug.
“The new initiative builds on this robust database we have from Get With The Guidelines to help us identify best practices that enable hospitals to further improve quality of care and outcomes in acute stroke care.”
Additional co-authors are Mathew J. Reeves, Ph.D.; Eric E. Smith, M.D., M.P.H.; Jeffrey L. Saver, M.D.; Xin Zhao, M.S.; DaiWai Olson, Ph.D.; Adrian F Hernandez, M.D. M.H.S.; and Eric D. Peterson, M.D., M.P.H. Author disclosures are on the manuscript.
Get With The Guidelines–Stroke is supported in part by an unrestricted educational grant from Merck/Schering-Plough Pharmaceutical.
Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.americanheart.org/corporatefunding.
NR10– 1041 (CircQO/Fonarow)
Cathy Lewis | EurekAlert!
Smart Data Transformation – Surfing the Big Wave
02.12.2016 | Fraunhofer-Institut für Angewandte Informationstechnik FIT
Climate change could outpace EPA Lake Champlain protections
18.11.2016 | University of Vermont
In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.
Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...
Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.
The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...
16.11.2016 | Event News
01.11.2016 | Event News
14.10.2016 | Event News
08.12.2016 | Life Sciences
08.12.2016 | Physics and Astronomy
08.12.2016 | Materials Sciences