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Stroke


A stroke occurs when the blood flow to the brain is suddenly stopped and oxygen does not reach part of the brain. Strokes can be caused by a blood clot or other blockage in the brain or by bleeding in the brain.

Symptoms of a stroke can include sudden severe headache, dizziness, nausea, vomiting, confusion, or difficulty speaking or walking. Other symptoms are possible, including numbness, tingling, weakness on one side of the body, or visual problems such as blindness or blurred or double vision. Recognizing stroke symptoms and seeking immediate care may reduce permanent damage to the brain.

The indicators in this section examine how well we manage the care of patients who are hospitalized for stroke. Norton Healthcare performance represents the performance of all the hospitals combined.

Stroke - percent of patients
% of stroke measure opportunities met (composite). (elements: stk01, stk02, stk03, stk04, stk05, stk06, stk08, stk10) % of stroke measure opportunities met (composite) high 95 98 98 98   97    
Number of stroke patients who received venous thromboembolism (VTE) prophylaxis or have a documented reason for not receiving it on the day of or the day after hospitalization. Includes ischemic and hemorrhagic stroke patients. Excludes patients enrolled in a clinical trial and those admitted for an elective carotid intervention.(STK-1) who received venous thromboembolism (VTE) prophylaxis high 95 100 98 95   98   96
Number of ischemic stroke patients who were prescribed antithrombotic therapy at discharge from the hospital. Excludes patients with a hemorrhagic stroke, those enrolled in a clinical trial, and those who were admitted for an elective carotid intervention. Includes only those patients discharged home.(STK-2) discharged on antithrombotic therapy high 99 100Quality Ribbon 100Quality Ribbon 100Quality Ribbon   100   99
Number of ischemic stroke patients with atrial fibrillation or flutter who were prescribed anticoagulation therapy at discharge from the hospital. Excludes patients with a hemorrhagic stroke, those enrolled in a clinical trial, and those who were admitted for an elective carotid intervention.(STK-3) with atrial fib. discharged on anticoagulation therapy high 88 95 100Quality Ribbon #   93   96
Number of ischemic stroke patients who had IV t-PA initiated within 3 hours of symptom onset. Includes patients who arrived at the hospital within 2 hours of last known well. Excludes patients with a hemorrhagic stroke, those enrolled in a clinical trial, and those who were admitted for an elective carotid intervention.(STK-4) who received thrombolytic therapy (IV t-PA) high # # # #   78   78
Number of ischemic stroke patients receiving antithrombotic therapy by end of hospital day 2. Excludes patients with a hemorrhagic stroke, those enrolled in a clinical trial, those discharged before the end of hospital day 2, those who were admitted for an elective carotid intervention, and those who received IV t-PA at this hospital or within 24 hours prior to arrival.(STK-5) who received antithrombotic therapy by end of day 2 high 97 99 98 100Quality Ribbon   98   98
Number of ischemic stroke patients with an LDL level greater than or equal to 100, or LDL not measured, or who were on a lipid-lowering medication on admission who were prescribed statin medication at discharge from the hospital. Includes patients who were on a lipid-lowering medication on admission, those with an LDL not measured, and those with an LDL level greater than or equal to 100. Excludes patients with a hemorrhagic stroke, those enrolled in a clinical trial, those who were admitted for an elective carotid intervention, and those who have no evidence of atherosclerosis.(STK-6) discharged on statin medication high 93 91 96 95   93   96
Number of stroke patients or their caregivers who were given stroke education materials addressing all of the following: activation of EMS, follow-up after discharge, medications prescribed at discharge, risk factors for stroke, and warning signs and symptoms of stroke. Includes ischemic and hemorrhagic stroke patients. Excludes patients enrolled in a clinical trial, those admitted for an elective carotid intervention, and those who were not discharged home.(STK-8) given stroke educational materials high 89 97 93 96   93   93
Number of stroke patients assessed for rehabilitation services. Includes ischemic and hemorrhagic stroke patients. Excludes patients enrolled in a clinical trial and those admitted for an elective carotid intervention.(STK-10) assessed for rehabilitation services high 97 99 98 99   98   98
inpatients who die- percent of patients with
Number of acute stroke patients per 100, who died in the hospital. Risk-adjusted using patient age, severity of illness, and risk of mortality (APR-DRG version 20). Includes inpatients 18 years and older discharged with a principal diagnosis of stroke. Excludes patients with missing discharge dispositions or patients transferred to an acute care hospital.(AHRQ IQI 17) acute stroke (AHRQ risk-adj.) low 6.2 7.5 5.8 4.1   6.5   9.4
Miscellaneous
Participation in a Systemic Clinical Database Registry for Stroke Care.(CMS) Is the hospital in a clinical database registry for stroke care? high yes yes yes yes   yes    
Percentage of stroke patients with restored blood flow to the brain following treatment Percentage of ischemic stroke patients with a post-treatment reperfusion grade of Thrombolysis in Cerebral Infarction (TICI) 2B or higher in the vascular territory beyond the target arterial occlusion at the end of treatment with intra-arterial (IA) thrombolytic (tPA) therapy and/or mechanical endovascular reperfusion therapy. For Grade 2B, there is complete perfusion, yet filling is slower than normal. For Grade 3, there is complete perfusion with normal filling. Excludes patients with hemorrhagic stroke or transient ischemic attack (TIA). % stroke patients with restored blood flow to brain after treatment high   63       63    

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