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Stroke

A stroke occurs when the blood flow to the brain is disrupted.   When this disruption occurs, the brain cells in the direct area begin to die.  These brain cells die from the lack of oxygen and nutrients they need to survive is not being met.  The following list of measures should be followed by a hospital to provide standard care to patients who have experienced a stroke.

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Data reflects current CMS Hospital Compare website, which shows data collected 4/1/2014 – 3/31/2015.


Stroke

LGH State National

Anticoagulation Therapy for Atrial Fibrillation/Flutter

Patients admitted to the hospital for a stroke who are found to have an irregular heart beat (also known as atrial fibrillation or flutter) are at greater risk of having another stroke. In this situation it is recommended that patients are started on anticoagulation therapy. Anticoagulation therapy consists of a medicine that thins the blood to reduce the chance of another stroke. Examples of some of the medications that may be used are Warfarin-Coumadin, Pradaxa, and Brilinta. This measure shows the percentage of patients admitted with a stroke who were prescribed an anticoagulant before they were discharged from the hospital. A higher percentage is better.
95.3% 98% 97%

Antithrombotic Therapy by End of Hospital Day 2

Research demonstrates that hospitals should start a medicine to reduce death, disability, and the risk for future strokes within two days of a stroke patient arriving at the hospital. This medicine is referred to as antithrombotic therapy. Antithrombotic therapy includes but is not limited to aspirin and Plavix. Antithrombotic therapy may be different for each patient based on their needs. This measure shows the percentage of stroke patients admitted to the hospital who received treatment to prevent blood clots on the day of admission or the day after, or had documentation in their chart explaining why they did not receive the treatment. A higher percentage is better.
99% 99% 99%

Blood Clot Prevention

Stroke patients are at an increased risk for developing a blood clot. It is recommended that a preventive therapy be used for at-risk patients. This may include, but is not limited to, Lovenox and Heparin. A higher percentage is better. This measure shows the percentage of patients admitted with a stroke who got a blood clot prevention therapy started within 2 days of arriving in the hospital.
100% 98% 97%

Discharged on Antithrombotic Therapy

The goal of antithrombotic therapy is to block the formation of new clots, prevent the growth of existing clots, and reduce the risk of complications from a stroke. Research suggests antithrombotic therapy should be prescribed at discharge. Depending on the type of stroke, antithrombotic therapy will vary. This measure shows the percentage of patients admitted with a stroke who were prescribed an anticoagulant before discharge from the hospital. A higher percentage is better.
99.5% 100% 99%

Discharged on Statin Medication

For patients who experience a stroke and also have high cholesterol, taking a statin can help lower the chance of another stroke. A statin is defined as a medication that can reduce LDL (“bad cholesterol”) and increase HDL (“good cholesterol”). These effects help prevent a patient’s risk of a heart attack, stroke, and other heart problems. (Examples: atorvastatin, pravastatin, rosuvastatin, simvastatin.) This measure shows the percentage of stroke patients who were prescribed a statin medication on discharge. A higher percentage is better.
98.4% 98% 97%

Evaluated for Rehabilitation Services

Many stroke patients will experience some level of disability, including physical, speech and mental functions. It is recommend that once a stroke patient is controlled, hospital staff should begin rehabilitation as soon as possible. Rehabilitation can help patient relearn some of the functions lost and regain their independence. Rehabilitation services will begin in the hospital and, if needed, continue once the patient is discharged. This measure shows the percentage of patients admitted with a stroke who are evaluated for their need for rehab. A higher percentage is better.
97.3% 99% 98%

Stroke Education

This measure shows the percentage of patients who received the appropriate stroke education during their hospital stay. A higher percentage is better.
97.9% 95% 94%

Thrombolytic Therapy

Research has shown that hospitals should give a medicine known as t-PA, tissue plasminogen activator, to break up a blood clot within 3 hours after the start of stroke symptoms. T-PA may not be applicable to every patient experiencing a stroke. For those able to receive it, t-PA can limit the injury and disability caused by a stroke. This measure shows the percentage of patients admitted with a stroke who arrived in the Emergency Department within 2 hours of the start of their symptoms and got the t-PA within 3 hours of the start of their symptoms. A higher percentage is better.
82.9% 81% 81%
 
 





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