Nav: Home

Better patient outcome linked to get with the guidelines-stroke

April 14, 2016

DALLAS, April 14, 2016 -- Stroke patients at hospitals participating in a nationwide quality-improvement program were more likely to be discharged home and less likely to die after discharge than patients in non-participating hospitals, according to new research in the American Heart Association's journal Stroke.

The program, Get With The Guidelines®-Stroke, established by the American Heart Association/American Stroke Association in 2003, helps hospitals provide stroke patients with the latest, most effective treatment for stroke. More than 1,600 hospitals have registered to receive patient-management toolkits, access to workshops, decision support, and many other resources.

"We know that in the past the Get With The Guidelines-Stroke program was associated with improved processes of care, such as appropriate medications and other interventions to prevent complications," said Sarah Song M.D., M.P.H., lead author of the study and an assistant professor in neurology at Rush University Medical Center in Chicago, IL. "Now we know that this improved care translates into improved clinical outcomes."

In this study, stroke patients who received treatment at hospitals participating in Get With The Guidelines-Stroke program were 10 percent more likely than those in non-participating hospitals to be discharged home, rather than to a rehabilitation center or other facility. Furthermore, 30 days and one year after discharge, patients from participating hospitals were 7-8 percent less likely to have died. These findings mean that participating hospitals would discharge 12 more stroke patients home for every 1,000 patients than non-participating hospitals, and 34 fewer patients would have died within one year.

A stroke is a medical emergency that occurs when a blood vessel either bursts or becomes blocked by fatty substances or a blood clot, interrupting blood flow to the brain. Without immediate treatment, cells in the brain begin to die, resulting in brain damage, paralysis, or even death. Warning signs and the necessary response are face drooping; arm or leg weakness or numbness; speech difficulty; time to call 9-1-1, or F.A.S.T.

In the United States, stroke is the fifth-leading cause of death, killing someone about every four minutes.

"By improving the infrastructure for stroke care, the program has been effective, not only in improving measures of process and care, but also clinical outcomes, which is what patients should care about most," Song said. "Stroke patients in hospitals with Get With The Guidelines-Stroke tended to do better, were less likely to die and more likely to go home after hospital discharge."

The study consisted of 173,985 Medicare patients with stroke caused by a blocked blood vessel. Roughly half of participants received treatment at hospitals participating in Get With The Guidelines-Stroke, while the other half was treated at non-participating hospitals. Participants' average age was 79 years, three-fifths were women, and most were white.

Investigators analyzed data from the Centers for Medicare & Medicaid Service for 366 hospitals participating in Get With The Guidelines-Stroke and 366 non-participating hospitals. The study ran from April 1, 2003 to December 1, 2008, data collection began 18 months before participating hospitals' joined the program, and follow-up was up to 18 months after program implementation.

A study limitation is that unforeseen factors could have affected the results, although investigators did match patients and hospitals in terms of their characteristics. In addition, the study did not measure disability after hospital discharge and could not control for whether or not patients followed treatment recommendations after leaving the hospital. This study was also done only in the Medicare population, so only in people aged 65 or older.
Co-authors are Gregg C. Fonarow, M.D.; DaiWai M. Olson, Ph.D., R.N.; Li Liang, Ph.D.; Phillip J. Schulte, Ph.D.; Adrian F. Hernandez, M.D., M.S.; Eric D. Peterson, M.D., M.P.H.; Mathew J. Reeves, Ph.D.; Eric E. Smith, M.D., M.P.H.; Lee H. Schwamm, M.D.; and Jeffrey L. Saver, M.D.

Author disclosures are on the manuscript.

The University of California, Los Angeles; Charles Drew University; Resource Centers for Minority Aging Research Center for Health Improvement of Minority Elderly under NIH/National Institute on Aging Grant P30-AG021684; the UCLA Clinical and Translational Science Institute under NIH/National Center for Advancing Translational Sciences Grant Number UL1TR000124; the National Institute of Neurological Disorders and Stroke of the National Institutes of Health under Award Number U54NS081764; and an award to UCLA from the AHA PRT and David and Stevie Spina supported the study. A charitable contribution from Janssen Pharmaceutical Companies of Johnson & Johnson supports, in part, Get With The Guidelines-Stroke (GWTG-Stroke), which is provided by the American Heart Association. In the past, Boeringher-Ingelheim; Merck, Bristol-Myers Squib/Sanofi Pharmaceutical Partnership; and the AHA Pharmaceutical Roundtable supported the program.

Additional Resources:

Researcher photo, stroke graphics, and stroke animation are located in the right column of this release link

After April 14, EMBARGO DATE , view the manuscript online.

Follow AHA/ASA news on Twitter @HeartNews.

For stroke science, follow the Stroke journal at @StrokeAHA_ASA

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at

American Heart Association

Related Stroke Articles:

How to help patients recover after a stroke
The existing approach to brain stimulation for rehabilitation after a stroke does not take into account the diversity of lesions and the individual characteristics of patients' brains.
Kids with headache after stroke might be at risk for another stroke
A new study has found a high incidence of headaches in pediatric stroke survivors and identified a possible association between post-stroke headache and stroke recurrence.
High stroke impact in low- and middle-income countries examined at 11th World Stroke Congress
Less wealthy countries struggle to meet greater need with far fewer resources.
Marijuana use might lead to higher risk of stroke, World Stroke Congress to be told
A five-year study of hospital statistics from the United States shows that the incidence of stroke has risen steadily among marijuana users even though the overall rate of stroke remained constant over the same period.
We need to talk about sexuality after stroke
Stroke survivors and their partners are not adequately supported to deal with changes to their relationships, self-identity, gender roles and intimacy following stroke, according to new research from the University of Sydney.
Standardized stroke protocol can ensure ELVO stroke patients are treated within 60 minutes
A new study shows that developing a standardized stroke protocol of having neurointerventional teams meet suspected emergent large vessel occlusion (ELVO) stroke patients upon their arrival at the hospital achieves a median door-to-recanalization time of less than 60 minutes.
Stroke affects more than just the physical
A new study looks at what problems affect people most after a stroke and it provides a broader picture than what some may usually expect to see.
Stroke journal features women's studies on how gender influences stroke risk, treatment and outcomes
Many aspects of strokes affect women and men differently, and four articles in the American Heart Association's journal Stroke highlight recent research and identify future research needs.
Too few with stroke of the eye are treated to reduce future stroke
Only one-third of 5,600 patients with retinal infarction, or stroke in the eye, underwent basic stroke work-up, and fewer than one in 10 were seen by a neurologist.
Juvenile stroke: Causes often not known
Strokes without a definitive identifiable cause account for up to 50 percent of juvenile strokes.
More Stroke News and Stroke Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

In & Out Of Love
We think of love as a mysterious, unknowable force. Something that happens to us. But what if we could control it? This hour, TED speakers on whether we can decide to fall in — and out of — love. Guests include writer Mandy Len Catron, biological anthropologist Helen Fisher, musician Dessa, One Love CEO Katie Hood, and psychologist Guy Winch.
Now Playing: Science for the People

#543 Give a Nerd a Gift
Yup, you guessed it... it's Science for the People's annual holiday episode that helps you figure out what sciency books and gifts to get that special nerd on your list. Or maybe you're looking to build up your reading list for the holiday break and a geeky Christmas sweater to wear to an upcoming party. Returning are pop-science power-readers John Dupuis and Joanne Manaster to dish on the best science books they read this past year. And Rachelle Saunders and Bethany Brookshire squee in delight over some truly delightful science-themed non-book objects for those whose bookshelves are already full. Since...
Now Playing: Radiolab

An Announcement from Radiolab