Table 2.
Acute stroke in-hospital process of care metrics in relation to post-stroke outcomes within 1 year in the FSR. These results were generated from multi-level logistic regression models to account for clustering within hospitals.
| Acute Care Metric OR (95% CI)* | In-hospital mortality (N=484 outcomes) | 30-day mortality (N=1637 outcomes) | 6-month mortality (N=2997 outcomes) | One-year mortality (N=3682 outcomes) | 30-day readmissions (N=1995 outcomes) |
|---|---|---|---|---|---|
| rt-PA, arrive by 2 hrs and treat by 3 hrs | |||||
| Model 1 | 0.66 (0.29–1.50) | 0.88 (0.44–1.73) | 0.88 (0.48–1.61) | 0.78 (0.46–1.33) | 1.04 (0.55–1.96) |
| Model 2 | 0.61 (0.26–1.44) | 0.84 (0.41–1.70) | 0.85 (0.45–1.60) | 0.76 (0.44–1.30) | 1.15 (0.60–2.22) |
| Early Antithrombotic Use | |||||
| Model 1 | 0.66 (0.42–1.03) | 0.58 (0.44–0.77) | 0.62 (0.52–0.75) | 0.65 (0.51–0.82) | 0.85(0.69–1.06) |
| Model 2 | 0.66 (0.42–1.03) | 0.59 (0.44–0.79) | 0.63 (0.51–0.77) | 0.66 (0.50–0.87) | 0.87(0.71–1.08) |
| Antithrombotics at Discharge | |||||
| Model 1 | 0.17(0.09–0.32) | 0.37 (0.24–0.58) | 0.55 (0.40–0.74) | 0.57 (0.43–0.76) | 0.97(0.75–1.25) |
| Model 2 | 0.20(0.10–0.38) | 0.39 (0.23–0.64) | 0.55 (0.40–0.76) | 0.56 (0.42–0.75) | 0.95(0.75–1.21) |
| Anticoagulation for Atrial Fibrillation | |||||
| Model 1 | 0.88 (0.19–4.13) | 0.69 (0.36–1.31) | 0.82 (0.56–1.19) | 0.79 (0.55–1.14) | 1.09 (0.66–1.81) |
| Model 2 | |||||
| Smoking Cessation Counseling | |||||
| Model 1 | 1.01 (0.43–2.42) | 1.17 (0.47–2.92) | 1.14 (0.51–2.56) | ||
| Model 2 | 1.15 (0.48–2.72) | 1.39 (0.58–3.37) | 1.29 (0.55–3.04) | ||
| LDL 100 or ND – Statin | |||||
| Model 1 | 0.54(0.28–1.05) | 0.74 (0.51–1.08) | 0.75 (0.59–0.95) | 0.68 (0.55–0.85) | 0.85 (0.73–0.98) |
| Model 2 | 0.52(0.27–1.00) | 0.75 (0.51–1.10) | 0.74 (0.58–0.95) | 0.68 (0.55–0.85) | 0.85 (0.75–0.98) |
| VTE prophylaxis | |||||
| Model 1 | 0.83 (0.59–1.16) | 1.00 (0.80–1.25) | 0.94 (0.79–1.12) | 0.90 (0.77–1.06) | .03 (0.86–1.24) |
| Model 2 | 0.81 (0.58–1.14) | 0.97 (0.78–1.22) | 0.92 (0.77–1.04) | 0.89 (0.73–1.06) | 1.02 (0.85–1.23) |
Model 1: Controlling for age, sex, race/ethnicity, and NIHSS
Model 2: Controlling for age, sex, race/ethnicity, NIHSS, health insurance status, mode of arrival, current smoker, hypertension, diabetes, dyslipidemia, and medical history of atrial fibrillation, coronary artery disease/prior myocardial infarction, and previous stroke/transient ischemic attack, and hospital-level factors including number of beds, years in GWTG-S and academic vs. not
*
Results are missing from models that did not converge