Treatment outcomes

One way to evaluate the care of patients diagnosed with stroke is to look at the percentage of patients receiving the timely and effective care measures that are appropriate. The goal is 100 percent.

The graph below displays the percentage of eligible Mayo Clinic patients diagnosed with stroke receiving all of the appropriate care measures.

Stroke core measure

Chart.


Timely and effective care

The following table reflects the timely and effective care measures for stroke.
Timely and Effective Care for Stroke Patients Explanation of Care
Percent of ischemic and hemorrhagic stroke patients who received venous thromboembolism (VTE) prophylaxis the day of or the day after hospital admission Stroke patients are at increased risk of developing venous thromboembolism (deep vein blood clots). Clinical practice guidelines for the prevention of VTE recommend the use of preventive therapies in at-risk patients.
Percent of ischemic stroke patients prescribed antithrombotic therapy at hospital discharge An antithrombotic agent is a drug that reduces the formation of blood clots. Studies suggest that antithrombotic therapy should be prescribed at hospital discharge following an ischemic stroke to reduce stroke mortality and morbidity.
Percent of ischemic stroke patients with atrial fibrillation or atrial flutter who are prescribed anticoagulation therapy at hospital discharge Anticoagulation therapy is a course of drug therapy in which medications are administered to a patient to slow the rate at which the patient's blood clots. Nonvalvular atrial fibrillation is a common arrhythmia and an important risk factor for stroke. Arrhythmia means that the heart's normal beating rhythm is interrupted. The administration of anticoagulation therapy is an effective strategy in preventing recurrent stroke in high stroke risk-atrial fibrillation patients.
Percent of acute ischemic stroke patients who arrive at this hospital within 2 hours of time last known well and for whom IV t-PA was initiated at this hospital within 3 hours of time last known well The goal is to quickly get rid of any blood clot(s) to restore function to the area that is impacted by a stroke, such as the brain. This may be achieved by administering the t-PA drug intravenously to eligible patients within three hours of stroke onset.
Percent of ischemic stroke patients who received antithrombotic therapy by the end of hospital day two An antithrombotic is a medication that prevents blood clots. Studies at this time suggest that antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity.
Percent of ischemic stroke patients with an LDL greater than or equal to 70 mg/dL, or LDL not measured, or who were on a lipid-lowering medication prior to hospital arrival are prescribed statin medication at hospital discharge Statin drugs are medications used to reduce serum level of lipids such as cholesterol. The reduction of LDL cholesterol, through lifestyle modification and drug therapy when appropriate, is recommended for the prevention of recurrent ischemic stroke, heart attack, and other major vascular events.
Percent of ischemic or hemorrhagic stroke patients, or their caregivers, who were given educational materials during the hospital stay addressing all of the following: activation of emergency medical system, need for follow-up after discharge, medications prescribed at discharge, risk factors for stroke, and warning signs and symptoms of stroke Patient education should include information about the event (e.g., cause, treatment, and risk factors), the role of various medications or strategies, as well as desirable lifestyle modifications to reduce risk or improve outcomes. Family/caregivers will also need guidance in planning effective and realistic care strategies appropriate to the patient's prognosis and potential for rehabilitation.
Percent of ischemic or hemorrhagic stroke patients who were assessed for rehabilitation services Stroke is a leading cause of serious, long-term disability in the United States. Early rehabilitation interventions initiated following stroke can enhance the recovery process and minimize functional disability. The primary goal of rehabilitation is to prevent complications, minimize impairments, and maximize function.
Appropriate care measure (ACM) The ACM is a pass-fail measure at the individual patient level that asks whether an eligible patient has received all of the appropriate care for the condition for which he or she is being treated.

Carotid Endarterectomy Mortality Rate

See related graph.

Carotid Stenting Mortality Rate

See related graph.

Comprehensive Stroke Measure

See related graph.

Comprehensive Stroke – Post Thrombolysis Revascularization Rate

See related graph.

Comprehensive Stroke – Timeliness of IV t-PA Therapy

See related graph.

For additional information and data visit Medicare Hospital Compare.

For additional information about quality at Mayo Clinic visit Quality Measures.

Feb. 21, 2017
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