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Abstract 206: Aiming to Improve Stroke Care Continuity with Primary Care Follow-up Appointments Scheduled Prior to Hospital Discharge Session Title: Poster Session II
Conclusions: Hospital performance with scheduling primary care follow-up appointments improved significantly; however, only 1 in 4 patients had an appointment scheduled prior to discharge. Case study analysis of missed opportunities may help identify barriers and facilitators associated with access, availability, and awareness that can be addressed in future improvement cycles.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Prvu Bettger, J., Burns, B., Lender, S., Nutter, D., On Behalf of the Ohio Coverdell Stroke Program Leadership, Participating Hosps and Partners Tags: Session Title: Poster Session II Source Type: research

Electronic Stroke CarePath: Integrated Approach to Stroke Care Innovations in Care
We describe the development, implementation, and outcomes of the first 2 years of the Electronic Stroke CarePath, an initiative developed for management of ischemic stroke patients in an effort to improve efficiency and quality of care for patients. The CarePath consists of care pathways for ischemic stroke that are integrated within the electronic health record. Patient-reported outcomes are collected using an external software platform. Documentation tools, order sets, and clinical decision support were designed to improve efficiency, optimize process measure adherence, and produce clinical data as a byproduct of care th...
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Katzan, I. L., Fan, Y., Speck, M., Morton, J., Fromwiller, L., Urchek, J., Uchino, K., Griffith, S. D., Modic, M. Tags: Ischemic Stroke Innovations in Care Source Type: research

Characteristics and Outcomes of Stroke Patients Transferred to Hospitals Participating in the Michigan Coverdell Acute Stroke Registry Original Articles
Conclusions— Transferred patients represent a complex admixture of patient characteristics that result in higher risks of poor outcomes. Our results suggest that it is prudent to account for patient transfer status when comparing hospital outcomes and that stroke registries need to expand their data collection capacity to provide a better understanding of the relative benefits and risks of transferring patients.
Source: Circulation: Cardiovascular Quality and Outcomes - May 16, 2016 Category: Cardiology Authors: Nickles, A. V., Roberts, S., Shell, E., Mitchell, M., Hussain, S., Lyon-Callo, S., Reeves, M. J. Tags: Complications, Mortality/Survival, Quality and Outcomes, Cerebrovascular Disease/Stroke Original Articles Source Type: research

Patterns of Emergency Medical Services Use and Its Association With Timely Stroke Treatment: Findings From Get With the Guidelines-Stroke Original Articles
Conclusions— Although EMS use is independently associated with more rapid evaluation and treatment of stroke, more than one third of stroke patients fail to use EMSs. Interventions aimed at increasing EMS activation should target populations at risk, particularly younger patients and those of minority race and ethnicity.
Source: Circulation: Cardiovascular Quality and Outcomes - May 21, 2013 Category: Cardiology Authors: Ekundayo, O. J., Saver, J. L., Fonarow, G. C., Schwamm, L. H., Xian, Y., Zhao, X., Hernandez, A. F., Peterson, E. D., Cheng, E. M. Tags: Emergency treatment of Stroke Original Articles Source Type: research

Abstract 7: Risk of Intracranial Hemorrhage Among Acute Ischemic Stroke Patients Receiving Prior Antiplatelet Therapy and Treated with Intravenous Tissue Plasminogen Activator Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics
Conclusion: This study represents the largest clinical experience of the safety of thrombolysis in patients on prior antiplatelet therapy. Despite a higher incidence of sICH, the absolute excess risk appears small (0.67%). These findings support current guideline recommendations regarding use of intravenous tPA in patients on antiplatelet therapy with careful weighing of potential risk and benefit.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Xian, Y., Grau-Spulveda, M., Schwamm, L. H., Bhatt, D. L., Smith, E. E., Reeves, M. J., Federspiel, J., Thomas, L., Bettger, J. P., Laskowitz, D. T., Hernandez, A. F., Fonarow, G. C., Peterson, E. D. Tags: Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics Source Type: research

Abstract 106: Defining an International Standard Set of Patient-centered Outcome Measures After Stroke Session Title: Poster Session I
Conclusions: The stroke measure Standard Set is proposed for implementation to permit meaningful comparisons and increase value of stroke care worldwide using a simple, pragmatic strategy.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Salinas, J., ICHOM Stroke Measure Group Tags: Session Title: Poster Session I Source Type: research

Chronic Kidney Disease and Bleeding Complications After Intravenous Thrombolytic Therapy for Acute Ischemic Stroke Original Articles
Conclusions— Presence of CKD among patients with IS treated with intravenous tissue-type plasminogen activator is associated with higher unadjusted odds of symptomatic intracranial hemorrhage or serious systemic hemorrhage, but this is explained by non-CKD related factors.
Source: Circulation: Cardiovascular Quality and Outcomes - November 18, 2014 Category: Cardiology Authors: Ovbiagele, B., Smith, E. E., Schwamm, L. H., Grau-Sepulveda, M. V., Saver, J. L., Bhatt, D. L., Hernandez, A. F., Peterson, E. D., Fonarow, G. C. Tags: Cerebrovascular disease/stroke, Risk Factors, Acute Cerebral Infarction, Thrombolysis Original Articles Source Type: research

Abstract 10: Contraindications to Oral Anticoagulation in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) Concurrent I Session B: Oral Abstract Presentations on Stroke Topics
Conclusions. Contraindications to OAC therapy among AF patients are common and often due to high bleeding risk. Furthermore, many patients with reported contraindications are taking warfarin, suggesting that many contraindications to warfarin therapy are minor, relative, or temporary.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: O'Brien, E. C., Holmes, D., Koller, C. R., Singer, D. E., Ansell, J., Allen, L. A., Hylek, E. M., Kowey, P., Gersh, B., Fonarow, G. C., Mahaffey, K. W., Chang, P., Ezekowitz, M. D., Peterson, E. D., Piccini, J. P. Tags: Concurrent I Session B: Oral Abstract Presentations on Stroke Topics Source Type: research

Abstract 208: A Literature Review Of Indirect Cost Of Stroke Poster Session II
Conclusions: While the literature indicated that the indirect cost accounted for a significant portion of the economic burden of stroke, there is a clear need to develop improved methods to study costs and to better use or establish relevant data sources for such studies. With the aging population and increasing survival rate of stroke, both direct and indirect costs of stroke are likely to increase greatly. Interventions for stroke prevention as well as for improving quality of life among stroke patients are needed to contain both direct and indirect costs associated with stroke. More research investigating the indirect c...
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Joo, H., George, M. G., Fang, J., Wang, G. Tags: Poster Session II Source Type: research

Abstract 223: National and Regional Trends in Hospitalizations for Hemorrhagic Stroke after Acute Myocardial Infarction in the United States: 1999-2010 Poster Session II
Conclusions: From 1999 to 2010, the overall hospitalization rates of hemorrhagic stroke after AMI were relatively stable without significant changes across all subgroups. Thirty-day mortality rates remained largely unchanged over time. Stroke risk in the stroke belt was not found significantly higher comparing with non-stroke belt states.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Shi, R., Wang, Y., Lichtman, J. H., Dharmarajan, K., Masoudi, F. A., Dodson, J. A., Chen, J., Chaudhry, S. I., Spertus, J. A., Nallamothu, B. K., Krumholz, H. M. Tags: Poster Session II Source Type: research

Validity of International Classification of Disease Codes to Identify Ischemic Stroke and Intracranial Hemorrhage Among Individuals With Associated Diagnosis of Atrial Fibrillation Original Articles
Conclusions— Using ICD-9 stroke and AF codes to identify patients with stroke plus AF resulted in inaccuracies. Given the expanded financial and policy implications of patient-oriented research, conclusions derived solely from administrative data without validation of outcome events should be interpreted with caution.
Source: Circulation: Cardiovascular Quality and Outcomes - January 20, 2015 Category: Cardiology Authors: Thigpen, J. L., Dillon, C., Forster, K. B., Henault, L., Quinn, E. K., Tripodis, Y., Berger, P. B., Hylek, E. M., Limdi, N. A. Tags: Health policy and outcome research, Acute Cerebral Hemorrhage, Acute Cerebral Infarction Original Articles Source Type: research

Abstract 301: Healthcare Costs Following Stroke and Major Bleeding Events in Nonvalvular Atrial Fibrillation Patients Session Title: Poster Session III
Conclusions: NVAF patients who have a stroke or MB event incur higher healthcare costs relative to patients without events. Interventions preventing stroke or MB events have the potential to reduce the healthcare burden associated NVAF.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Naccarelli, G., Stokes, M., DeLeon, A., Tate, N., Wang, R., Wang, A., Fredell, J. Tags: Session Title: Poster Session III Source Type: research

Abstract 233: Trends in Referral to Post-Acute Care Services after an Acute Stroke Hospitalization in the U.S.: Findings from the Get With The Guidelines-Stroke Program Poster Session II
Conclusions: Since 2003 there was a slight increase in the proportion of stroke patients discharged to post-acute care among hospitals participating in GWTG-Stroke. However, 4 in 10 patients are discharged home without services. Over the last decade of payment reform, there has been modest change in types but not the overall referral to post-acute services for stroke patients.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Prvu Bettger, J., McCoy, L., Smith, E. E., Fonarow, G. C., Schwamm, L. H., Peterson, E. D. Tags: Poster Session II Source Type: research

Abstract 4: Variation in Published Stroke Rates Results in Wide Variation in the Net Clinical Benefit of Anticoagulation for Atrial Fibrillation Session Title: QCOR 2018 Young Investigator Award Finalists
Conclusion: Using current guidelines, variation in published off-anticoagulation stroke rates results in tenfold variation in the estimated net clinical benefit of anticoagulation. Guidelines should better reflect the uncertainty of the current approach that uses a CHA2DS2-VASc threshold to recommend anticoagulation.
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Shah, S. J., Eckman, M. H., Aspberg, S., Go, A. S., Singer, D. E. Tags: Session Title: QCOR 2018 Young Investigator Award Finalists Source Type: research

Abstract 235: Acute Care Measures of Rehabilitation Needs Associated with Discharge to Rehabilitation for Patients with Minor Stroke Poster Session II
Conclusions: Rehabilitation needs were documented for patients with minor stroke and almost one third were discharged to receive inpatient rehabilitation in an IRF or SNF. Taking pre-stroke disability into consideration for transition planning from acute care could facilitate earlier communication and planning with the next point of care.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Prvu Bettger, J., Stein, J., Magdon-Ismail, Z., Hedeman, R., Sicklick, A., Schwamm, L. H. Tags: Poster Session II Source Type: research

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