Abstract T MP38: Impact of Community Stroke Education and Comprehensive Stroke Care in South Texas
BACKGROUND AND PURPOSE: The purpose of this study was to evaluate the impact of our coordinated stroke education programs and establishment of comprehensive stroke care in South Texas border town on the utilization of and outcomes associated with thrombolytic use. Previous studies have identified prominent disparities in health care delivery in these regions of the United States
METHODS: We identified all patients who had a discharge diagnosis of ischemic stroke from January 2010 till July 2014 at one Primary
Stroke center in South Texas using ICD codes of 434.91, 433.31, 434.01 and 434.11. We studied the trend of growth in stroke care delivery over the last 5 years in the subset of patients who received intravenous recombinant tissue plasminogen activator (IV rt-PA) and those who were treated with endovascular interventions. Starting in July 2012, a public stroke education plan was implemented over an 18 month period. The plan included an annual stroke symposium, quarterly education with early response team members, quarterly lectures to surrounding emergency rooms, public radio and television advertisements in English and Spanish stressing the AHA F.A.S.T. acronym, billboards, and grand rounds with internal medicine, family practice and emergency room physicians at all of our referral hospitals.
RESULTS: Total number of ischemic stroke patients per year grew linearly from 343 in 2010 to over 550, as projected, in 2014.
Proportion of patients treated with IV rt-PA increased from 3.2% in 2010 to 13.8% in 2014. The significant increase in thrombolytic use was due to a greater proportion of patients arriving to the emergency room within 4.5 hours , with no difference in rates of post thrombolytic intracerebral hemorrhages . A total of 14.5% of acute ischemic stroke patients received endovascular treatment in 2014 compared with 6.3 % in 2012 when endovascular service was established. The proportion of patients who had either IV or endovascular treatment was 25.7% in 2014 compared with only 3.2% in 2010.
CONCLUSIONS: Intensified public stroke education and establishment of comprehensive stroke care significantly increased intravenous thrombolytic and endovascular treatment utilization in a South Texas border town over four fold within 18 months.
Author Disclosures: A.E. Hassan: None. W.G. Tekle: None. C. Sanchez: None. L. Jones-Fullingim: None. O. Sanchez: None. E. Abantao: None. A.A. Malik: None. A.I. Qureshi: None.
- © 2015 by American Heart Association, Inc.