Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Evidence-based care and outcomes improve at Get With The Guidelines -- Stroke hospitals

24.02.2010
Study highlights:
- A study looking at the first 1 million patients in the Get With The Guideline–Stroke program shows significant improvement in the use of evidence-based stroke therapies at participating hospitals.
- Among hospitals participating in the program, there were significant reductions in in-hospital death after ischemic stroke and transient ischemic attacks from 2003 to 2009.
- Researchers say this study demonstrates the value of quality improvement programs, such as Get With The Guidelines–Stroke, for improving the care and outcomes for stroke patients and providing a rich database of information for stroke research.

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!
Further information:
http://www.heart.org

More articles from Studies and Analyses:

nachricht Innovative genetic tests for children with developmental disorders and epilepsy
11.07.2018 | Christian-Albrechts-Universität zu Kiel

nachricht Oxygen loss in the coastal Baltic Sea is “unprecedentedly severe”
05.07.2018 | European Geosciences Union

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

Im Focus: Chemical reactions in the light of ultrashort X-ray pulses from free-electron lasers

Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.

Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

Global study of world's beaches shows threat to protected areas

19.07.2018 | Earth Sciences

New creepy, crawly search and rescue robot developed at Ben-Gurion U

19.07.2018 | Power and Electrical Engineering

Metal too 'gummy' to cut? Draw on it with a Sharpie or glue stick, science says

19.07.2018 | Materials Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>