A comprehensive study published in Stroke, the peer-reviewed journal of the American Stroke Association, has revealed significant improvements in acute stroke care over the past two decades. The research, which analyzed data from the American Heart Association's Get With The Guidelines® - Stroke registry from 2003 to 2022, demonstrates the crucial role of quality improvement programs in combating one of the nation's most pressing public health concerns. The study, led by Dr. Gregg C. Fonarow of the University of California, Los Angeles, examined nearly 8 million stroke cases from more than 2,800 hospitals across the United States. This extensive dataset represents approximately three-quarters of all stroke hospitalizations in the country, providing a comprehensive view of stroke care trends and outcomes.
Key findings from the research indicate substantial and sustained improvements in acute stroke care among hospitals participating in the Get With The Guidelines program. Notably, adherence to evidence-based stroke care practices has increased, resulting in better clinical outcomes and more efficient patient discharges. One of the most significant improvements observed was in the timeliness of treatment for ischemic strokes. The study found that the percentage of patients receiving thrombolytic therapy within one hour of arrival at the hospital nearly quadrupled. Even more impressive was the eight-fold increase in patients treated within 45 minutes. Similar advancements were noted in endovascular therapy, which involves using catheters to remove blood clots.
Dr. Fonarow emphasized the importance of these improvements, stating that stroke is an exquisitely time-sensitive disease and Get With The Guidelines promotes delivery of evidence-based acute stroke care in a timely fashion, which in turn improves patient-centered clinical outcomes. The study's findings are particularly significant given that stroke remains the fifth leading cause of death and the primary cause of long-term disability in the United States. The Get With The Guidelines - Stroke program, launched in 2003, was designed to address the wide variability in stroke management and ensure that patient care aligns with the latest research-based guidelines.
Since its inception, the program has expanded to include modules covering atrial fibrillation, coronary artery disease, heart failure, and resuscitation. Each module promotes consistent adherence to evidence-based guidelines and provides data for ongoing improvement in patient care. The research team conducted a registry-based retrospective observational cohort study, examining patient characteristics, adherence to performance measures, and in-hospital outcomes for various types of strokes and transient ischemic attacks. The analysis quantified temporal changes in performance measure adherence and clinical outcomes over time.
This study offers compelling evidence that concerted quality improvement initiatives can enhance stroke care delivery and patient outcomes across diverse populations and locations. As the American Heart Association celebrates its centennial year in 2024, this research underscores the organization's continued commitment to improving cardiovascular health and reducing the impact of stroke. The positive trends observed in this study suggest that ongoing efforts to implement and refine quality improvement programs in stroke care can lead to significant advancements in patient outcomes and overall public health. As stroke remains a major health concern, the insights gained from this research may inform future strategies to further enhance stroke care and reduce its burden on individuals and healthcare systems.
