Twenty Years of Sustained Improvement in Quality of Care and Outcomes for Patients Hospitalized With Stroke or Transient Ischemic Attack: Data From The Get With The Guidelines-Stroke Program

 THIS IS ABSOLUTELY APPALLING! Talking about 'care' instead of RECOVERY! Which is why I consider the AHA/ASA one of the fucking failures of stroke associations!

Not even measuring 100% recovery which is what every survivor wants!

Here's your 100% recovery failure statistics!

tPA full recovery is only 12%

Only 10% get to full recovery.

“What's measured, improves.” So said management legend and author Peter F. Drucker 

The latest crapola here:

Twenty Years of Sustained Improvement in Quality of Care and Outcomes for Patients Hospitalized With Stroke or Transient Ischemic Attack: Data From The Get With The Guidelines-Stroke Program

Ying Xian, MD, PhD https://orcid.org/0000-0002-1237-1162, Shen Li, MS https://orcid.org/0000-0001-9322-6516, Tian Jiang, MS, Chandler D. Beon, BA https://orcid.org/0000-0001-6868-0370, Remy Poudel, MPH https://orcid.org/0009-0008-2028-8773, Kathie Thomas, DHA, MPH https://orcid.org/0009-0006-1692-3282, Mathew J. Reeves, PhD https://orcid.org/0000-0002-8019-6343, … Show All … , and Gregg C. Fonarow, MD https://orcid.org/0000-0002-3192-8093 gfonarow@mednet.ucla.eduAuthor Info & Affiliations

Stroke

New online

https://doi.org/10.1161/STROKEAHA.124.048174

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Abstract

BACKGROUND:

The Get With The Guidelines-Stroke program is a quality improvement initiative designed to enhance adherence to evidence-based stroke care(NOT RECOVERY!). Since its inception in 2003, over 2800 hospitals in the United States have participated in the program.

METHODS:

We examined patient characteristics, adherence to performance measures, and in-hospital outcomes in patients hospitalized for acute ischemic stroke, subarachnoid hemorrhage, intracerebral hemorrhage, and transient ischemic attack in The Get With The Guidelines-Stroke hospitals from 2003 through 2022. We quantified temporal changes in performance measure adherence and clinical outcomes over time. Performance measure denominators consisted of patients who were eligible, excluding those with contraindications.

RESULTS:

Over the 20 years of the program, a total of 7837 849 stroke cases (median age 71 years, 51.0% female; 69.2% ischemic strokes, 3.9% SAHs, 11.5% ICHs, and 15.3% TIAs) were entered into the registry. Except for antithrombotics at discharge, in which the baseline performance was >92%, there was sustained improvement in all performance metrics regardless of type of cerebrovascular event (P<0.01 for all). In patients with acute ischemic stroke, large improvements were observed for anticoagulation for atrial fibrillation (55.7% in 2003 to 97.2% in 2022), smoking cessation counseling (44.7%–97.8%), dysphagia screening (53.8%–83.5%), thrombolytic treatment for patients arriving by 3.5 hours, treat by 4.5 hours (15.2%–92.9%), door-to-needle time within 60 minutes (19.0%–75.3%), and endovascular door-to-puncture time within 90 minutes (54.7%–62.8%). Similar improvements were also observed for measures relevant to patients with subarachnoid hemorrhage, intracerebral hemorrhage, and transient ischemic attack. Multivariable analysis showed that there was a sustained increase in odds of receiving each performance measure over time, independent of patient and hospital characteristics for each type of cerebrovascular event. After risk adjustment, there were temporal trends that patients were less likely to be discharged to a skilled nursing facility, and, for ischemic stroke only, more likely to be discharged directly home.

CONCLUSIONS:

During the first 20 years, Get With The Guidelines-Stroke participation was associated with sustained improvement in evidence-based care(NOT RECOVERY!) and outcomes for patients with stroke and transient ischemic attack in the United States.

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