Table 3. Stroke Performance Measures, Treatments, and Outcomes, by Stroke Type Among Stroke Patients Admitted to Participating Hospitals From Weeks 11–24 in 2019 to Weeks 11–24 in 2020, Paul Coverdell National Acute Stroke Programa .
| Factor | Hemorrhagic Stroke |
Ischemic Stroke |
Transient Ischemic Attack |
||||||
|---|---|---|---|---|---|---|---|---|---|
| 2019 | 2020 | P Valueb | 2019 | 2020 | P Valueb | 2019 | 2020 | P Valueb | |
| Performance measures established by Paul Coverdell National Acute Stroke Program, % | |||||||||
| STK-1: Venous thromboembolism prophylaxis | 98.1 | 98.4 | .56 | 97.5 | 97.5 | .99 | — | — | — |
| STK-2: Discharged on antithrombotic therapy | — | — | — | 99.6 | 99.6 | .83 | 98.0 | 98.5 | .44 |
| STK-3: Anticoagulation therapy for atrial fibrillation/flutter | — | — | — | 98.0 | 97.7 | .59 | 94.0 | 96.3 | .39 |
| STK-4: Arrival in 2 h and alteplase given in 3 h of last known to be well | — | — | — | 94.3 | 93.5 | .54 | — | — | — |
| STK-5: Antithrombotic therapy by day 2 | — | — | — | 97.7 | 97.5 | .54 | 98.1 | 97.4 | .44 |
| STK-6: Discharged on statin medication | — | — | — | 98.7 | 98.6 | .89 | 94.7 | 95.9 | .39 |
| STK-7: Dysphagia screening | 84.3 | 85.2 | .56 | 87.0 | 87.7 | .12 | — | — | — |
| STK-8: Stroke education | 92.7 | 92.8 | .93 | 95.3 | 95.3 | .95 | 92.1 | 91.4 | .50 |
| STK-9: Smoking cessation counseling | 97.9 | 98.1 | .93 | 98.7 | 98.1 | .23 | 95.7 | 95.7 | .98 |
| STK-10: Assessed for rehabilitation | 98.7 | 99.0 | .56 | 99.3 | 99.3 | .83 | — | — | — |
| Defect-free care | 83.7 | 84.7 | .56 | 81.8 | 82.0 | .83 | 87.7 | 88.1 | .79 |
| Treatment, % | |||||||||
| Intravenous thrombolysis or intra-arterial reperfusion treatment | — | — | — | 17.0 | 17.7 | .12 | — | — | — |
| Intravenous thrombolysis reperfusion treatment only | — | — | — | 55.7 | 50.6 | <.001 | — | — | — |
| Intra-arterial reperfusion treatment only | — | — | — | 34.1 | 39.8 | <.001 | — | — | — |
| Intravenous thrombolysis and intra-arterial reperfusion treatment | — | — | — | 10.2 | 9.5 | .55 | — | — | — |
| Any complication after reperfusion therapyc | — | — | — | 4.0 | 4.5 | .54 | — | — | — |
| Among patients given intravenous thrombolysis reperfusion treatment | |||||||||
| Time between last known to be well and emergency department arrival, median (IQR), min | — | — | — | 68 (44–115) | 70 (44–119) | .54 | — | — | — |
| Time between last known to be well and intravenous thrombolysis administered, median (IQR), min | — | — | — | 125 (89–174) | 129 (89–178) | .22 | — | — | — |
| Time between emergency department arrival and intravenous thrombolysis administered, median (IQR), min | — | — | — | 49 (35–70) | 50 (34–70) | .94 | — | — | — |
| Time between emergency department arrival and intravenous thrombolysis administered ≤60 min, % | — | — | — | 66.5 | 66.2 | .95 | — | — | — |
| Time between emergency department arrival and intravenous thrombolysis administered ≤45 min, % | — | — | — | 43.6 | 43.4 | .96 | — | — | — |
| Among patients given intra-arterial reperfusion treatment | |||||||||
| Time between emergency department arrival and intra-arterial treatment administered, median (IQR), min | — | — | — | 92 (60–132) | 96 (62–139) | .12 | — | — | — |
| Outcomes, % | |||||||||
| Discharged to home | 29.4 | 29.7 | .86 | 49.7 | 50.9 | .04 | 83.6 | 84.6 | .47 |
| Discharged to hospice | 6.9 | 8.6 | .02 | 4.2 | 5.0 | <.001 | 0.7 | 0.6 | .79 |
| Discharged to acute care facility | 3.3 | 3.1 | .86 | 2.2 | 2.2 | .95 | 0.6 | 1.0 | .40 |
| Discharged to another health care facility | 39.4 | 36.6 | .02 | 38.5 | 35.3 | <.001 | 13.1 | 11.3 | .25 |
| In-hospital death | 20.7 | 21.4 | .56 | 4.3 | 5.0 | .003 | 0.1 | 0.5 | .08 |
Abbreviation: —, does not apply; IQR, interquartile range; STK, stroke.
a
Week 11 (March 10–16, 2019) to week 24 (June 9–15, 2019) defined as the pre–COVID-19 pandemic period and week 11 (March 8–14, 2020) to week 24 (June 7–13, 2020) as the COVID-19 pandemic weeks. Data source: Paul Coverdell National Acute Stroke Program.
b
False discovery rate-adjusted P values at threshold of 5%.
c
The complication of either symptomatic intracranial hemorrhage or life-threatening or serious systemic hemorrhage within 36 hours after treatment.