Abstract T P333: Impact of Secondary Prevention Therapy on Mortality after a First Ischemic Stroke in Puerto Rico
Background: Stroke is the fourth leading cause of death and the most prevalent cause of long-term disability in Puerto Rico. Prompt implementation of evidence-based clinical practice guidelines by physicians is crucial to reduce morbidity and mortality in patients with a first ischemic stroke.
Purpose: The purpose of this study is to evaluate the impact of prescription of secondary prevention therapies on mortality in Puerto Rican patients hospitalized with a first ischemic stroke.
Methods: This was a retrospective secondary data analysis of 2007 and 2009 Puerto Rico Stroke Registry electronic database. Information was obtained from the medical charts of patients discharged with ICD-9 codes 434 and 436 from 20 hospitals located in Puerto Rico. Descriptive analyses were conducted for demographics and comorbidities. Chi2 statistics compared the proportion of patients prescribed secondary prevention therapy and the proportion of patients not prescribed secondary prevention therapy. Lastly, survival rates were calculated to December 2010.
Results: The mean age of 3,965 patients was 70 years (+/-13.8) and 64% were females older than 84 years. The most frequent comorbidities were hypertension (85%), diabetes (52%), and hyperlipidemia (25%). Secondary prevention therapy was prescribed to 11% of the patients. The case-fatality-rate for patients prescribed secondary prevention therapy was 16% compared to 26% for patients not prescribed secondary prevention therapy (P< 0.01). The mean survival for stroke patients prescribed secondary preventions was 450 days, (95% CI,182-718) compared to 266 days, (95% CI, 244-287) for those not prescribed secondary prevention therapy (p= 0.175).
Conclusion: A low percentage of patients with first ischemic stroke were prescribed secondary prevention therapy. Although our findings suggest that secondary prevention therapy decreased mortality in patients with stroke, the difference did not reach statistical significance.
Author Disclosures: M.E. Rojas: None. W. Marsh: None. M. Felici: None. J. Acuña: None. R.J. Rodriguez: None. J.C. Zevallos: None.
- © 2014 by American Heart Association, Inc.