Quality of Care and Outcomes for Patients With Stroke in the United States Admitted During the International Stroke Conference.

Messé, Steven R

Mullen, Michael T

Cox, Margueritte

Fonarow, Gregg C

Smith, Eric E

Saver, Jeffrey L

Reeves, Mathew J

Bhatt, Deepak L

Matsouaka, Roland

Schwamm, Lee H

2020-09-01T15:53:38Z

2020-09-01T15:53:38Z

2018-11

2020-09-01T15:53:37Z

Background Patients presenting to hospitals during non-weekday hours experience worse outcomes, often attributed to reduced staffing. The American Heart Association International Stroke Conference ( ISC ) is well attended by stroke clinicians. We sought to determine whether patients with acute ischemic stroke ( AIS ) admitted during the ISC receive less guideline-adherent care and experience worse outcomes. Methods and Results We performed a retrospective cohort study of US hospitals participating in Get With The Guidelines-Stroke and assessed use of intravenous tissue plasminogen activator, other quality measures, and outcomes for patients with AIS admitted during the ISC compared with those admitted the weeks before and after the conference. A total of 69 738 patients with AIS were included: mean age, 72 years; 52% women; 29% nonwhite. There was no difference between the average weekly number of AIS cases admitted during ISC weeks versus non- ISC weeks (1984 versus 1997; P=0.95). Patient and hospital characteristics were similar between ISC and non- ISC time periods. There were no significant differences in 14 quality metrics and 5 clinical outcomes between patients with AIS treated during the ISC versus non- ISC weeks. Patients with AIS who presented within 2 hours of onset had no difference in the likelihood of receiving intravenous tissue plasminogen activator within 3 hours (adjusted odds ratio, 0.89; 95% confidence interval, 0.77-1.03; P=0.13) or the likelihood of receiving intravenous tissue plasminogen activator within 60 minutes of arrival (adjusted odds ratio, 0.92; 95% confidence interval, 0.83-1.02; P=0.13). Conclusions Patients with acute stroke admitted to Get With The Guidelines-Stroke hospitals during ISC received the same quality care and had similar outcomes as patients admitted at other times.

2047-9980

2047-9980

https://hdl.handle.net/10161/21406

eng

Ovid Technologies (Wolters Kluwer Health)

Journal of the American Heart Association

10.1161/jaha.118.009842

Humans

Acute Disease

Tissue Plasminogen Activator

Fibrinolytic Agents

Treatment Outcome

Patient Admission

Retrospective Studies

Cohort Studies

Aged

Quality of Health Care

Guideline Adherence

United States

Female

Male

Congresses as Topic

Stroke

Quality of Care and Outcomes for Patients With Stroke in the United States Admitted During the International Stroke Conference.

Journal article

Matsouaka, Roland|0000-0002-0271-5400

e009842

21

School of Medicine

Duke Clinical Research Institute

Biostatistics & Bioinformatics

Duke

Institutes and Centers

Basic Science Departments

Published

7