Table 21-5.
Time Trends in GWTG-Stroke Quality-of-Care Measures, 2006–2010
| Quality-of-Care Measure | 2006 | 2007 | 2008 | 2009 | 2010 |
|---|---|---|---|---|---|
| IV tPA in patients who arrived ≤2 h after symptom onset, treated in ≤3 h* | 55.8 | 60.2 | 63.9 | 73.1 | 76.2 |
| IV tPA in patients who arrived <3.5 h after symptom onset, treated in ≤4.5 h† | N/A | N/A | N/A | N/A | 42.5 |
| IV tPA door-to-needle time ≤60 min | 22.5 | 24.9 | 25.9 | 28.0 | 29.5 |
| Thrombolytic complications: IV tPA and life-threatening, serious systemic hemorrhage | 20.8 | 17.3 | 16.1 | 15.1 | 13.1 |
| Antithrombotics <48 h after admission* | 94.8 | 95.8 | 96.0 | 96.2 | 96.3 |
| DVT prophylaxis by second hospital day* | 85.3 | 88.9 | 92.2 | 92.7 | 92.2 |
| Antithrombotics at discharge* | 94.1 | 95.1 | 97.0 | 97.8 | 97.7 |
| Anticoagulation for atrial fibrillation at discharge* | 88.2 | 89.5 | 93.1 | 93.5 | 93.5 |
| Therapy at discharge if LDL cholesterol >100 mg/dL or LDL cholesterol not measured or on therapy at admission* | 70.3 | 76.3 | 82.1 | 86.2 | 88.1 |
| Counseling for smoking cessation* | 86.1 | 92.2 | 94.3 | 96.2 | 96.7 |
| Lifestyle changes recommended for BMI >25 kg/m2 | 42.5 | 45.7 | 51.7 | 57.3 | 57.8 |
| Composite quality-of-care measure | 85.9 | 88.9 | 91.7 | 93.3 | 93.7 |
GWTG-Stroke indicates Get With The Guidelines–Stroke; IV, intravenous; tPA, tissue-type plasminogen activator; N/A, not applicable; DVT, deep venous thrombosis; LDL, low-density lipoprotein; and BMI, body mass index.
Values are percentages.
In-hospital mortality for the 2010 patient population was 6.6% percent, and mean length of hospital stay was 4.9 days (median 3.0 days).
*
Indicates the 7 key achievement measures targeted in GWTG-Stroke.
†
New quality measure subsequent to the European Cooperative Acute Stroke Study III.