- Patients with ischemic stroke treated at hospitals participating in the Get With The Guidelines–Stroke (GWTG-Stroke) quality-improvement program had better care measures.
Why this matters
- Outcomes are better with evidence-based care, but adherence varies.
- 38% of patients treated in hospitals participating in GWTG-Stroke.
- Patients treated at participating vs nonparticipating hospitals more likely to receive:
- 5 of 10 recommended evidence-based interventions, including tissue plasminogen activator (relative risk, 3.74; 95% CI, 1.65-8.50);
- Education on risk factors (1.54; 1.16-2.05);
- Evaluation for swallowing (1.25; 1.04-1.50);
- Lipid evaluation (1.18; 1.05-1.32); and
- Evaluation by neurologist (1.12; 1.05-1.20).
- Mean number of interventions received was greater at participating hospitals (5.4 vs 4.8; P
- Editorial: Small and rural hospitals may lack resources for GWTG-Stroke participation. “This requires a shift in focus from hospital-level improvement to regional stroke systems of care to ensure that all patients have access to high-quality stroke care.”
- Prospective population-based cohort study of 546 patients experiencing ischemic stroke during 9-year follow-up of REGARDS Study.
- Main outcomes: quality-of-care measures.
- Funding: National Institute of Neurological Disorders and Stroke; American Stroke Association; Janssen Pharmaceutical Companies Johnson & Johnson; others.
- Reliance on medical records.
- Residual confounding.