Characteristics, Performance Measures, and In-Hospital Outcomes of the First One Million Stroke and Transient Ischemic Attack Admissions in Get With The Guidelines-Stroke (original) (raw)

Abstract

on behalf of the GWTG-Stroke Steering Committee and Investigators Background-Stroke results in substantial death and disability. To address this burden, Get With The Guideline (GWTG)-Stroke was developed to facilitate the measurement, tracking, and improvement in quality of care and outcomes for acute stroke and transient ischemic attack (TIA) patients in the United States. Methods and Results-We analyzed the characteristics, performance measures, and in-hospital outcomes in the first 1 000 000 acute ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and TIA admissions from 1392 hospitals that participated in the GWTG-Stroke Program 2003 to 2009. Patients were 53.5% women, 73.3% white, and with mean age of 70.1Ϯ14.9 years. There were 601 599 (60.2%) ischemic strokes, 108 671 (10.9%) intracerebral hemorrhages, 34 945 (3.5%) subarachnoid hemorrhages, 26 977 (2.7%) strokes not classified, and 227 788 (22.8%) TIAs. Performance measures showed small to moderate differences by cerebrovascular event type. In-hospital mortality rate was highest among intracerebral hemorrhage (25.0%) and subarachnoid hemorrhage (20.4%), and intermediate in ischemic stroke (5.5%) patients and lowest among TIA patients (0.3%). Significant improvements over time from 2003 to 2009 in quality of care were observed: all-or-none measure, 44.0% versus 84.3% (ϩ40.3%, PϽ0.0001).

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  23. + P-values are based on chi-square rank based group means score statistics for all categorical row variables (equivalent to Kruskal-Walis test for row variables with three or more levels and Wilcoxon test for two levels). P-values are based on chi-square one degree of freedom rank correlation statistics for all continuous/ordinal row variables (designated by *). All tests treat the column variable as ordinal (excludes overall column).
  24. ICH, intracerebral hemorrhage; IS ischemic stroke; OR, odds ratio, SNC, stroke not classified; SAH, subarachnoid hemorrhage; TIA, transient ischemic attack.