Howard G, et al. - For patients admitted to hospitals participating and not participating in Get With The Guidelines–Stroke (GWTG-Stroke), researchers compared the quality of stroke care measures. For patients with ischemic stroke hospitalized at participating hospitals, improved stroke care was documented in the data collected independently of the GWTG-Stroke program.

Methods

• A subpopulation of 546 participants with ischemic stroke taking place during a 9-year follow-up of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study, a population-based cohort study of 30,239 randomly selected black and white participants 45 years and older recruited between 2003 and 2007.
• Out of the patients with stroke, 207 (36%) were treated in a hospital participating in GWTG-Stroke and 339 in a nonparticipating hospital.
• They analyzed the data between July 29, 2017 and April 17, 2018.
• Main outcomes and measures were quality of care measures including use of tissue plasminogen activator, performance of swallowing evaluation, antithrombotic use in first 48 hours, lipid profile assessment, discharge receiving antithrombotic therapy, discharge receiving a statin, neurologist evaluation, providing weight loss and exercise counseling, education on stroke risk factors and warning signs, and assessment for rehabilitation.

Results

• Findings suggested that the participants treated at participating hospitals had a mean (SD) age of 74 (8) years and 100 of 207 were men (48%), while those seen at nonparticipating hospitals had a mean (SD) age of 73 (9) years, and 161 of 339 were men (48%).
• Results demonstrated a greater likeliness of those seen in participating hospitals to receive 5 of 10 evidence-based interventions recommended for patients hospitalized with ischemic stroke, including receiving tissue plasminogen activator (RR, 3.74; 95% CI, 1.65-8.50), education on risk factors (RR, 1.54; 95% CI, 1.16-2.05), having an evaluation for swallowing (RR, 1.25; 95% CI, 1.04-1.50), a lipid evaluation (RR, 1.18; 95% CI, 1.05-1.32), and an evaluation by a neurologist (RR, 1.12; 95% CI, 1.05-1.20).
• As per data, a mean of 5.4 (95% CI, 5.2-5.6) interventions were received by those seen in participating hospitals vs 4.8 (95% CI, 4.6-5.0) in nonparticipating hospitals (P < .001).