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Stroke and Cerebrovascular Volume Metrics

The Number of Patients Admitted with Stroke in 2018

For an explanation of the types of stroke, click here. The Cerebrovascular category is the number of patients who were admitted specifically for treatment of aneurysms, arteriovenous malformations (AVM), and blockages of blood vessels (stenosis, occlusion). For more cerebrovascular information, click here. For more information about these problems and treatments at Barnes-Jewish Hospital, click here.

Diagnosis/Case Type # Cases
Stroke
(Ischemic Stroke, Intracerebral Hemorrhage, Subarachnoid Hemorrhage, TIA)
1,322
Cerebrovascular
(Aneurysm, AVM, Moyamoya, Stenosis, Occlusion)
281
Total: 1,603

Total Stroke and Cerebrovascular Volume


Types of Stroke

For an explanation of the types of stroke, click here.

Types of Stroke # Cases
Ischemic Stroke 875
Intracerebral Hemorrhage 273
Subarachnoid Hemorrhage 108
TIA 66
Total: 1,322

Types of Stroke


Ischemic Stroke Treatment

The number of patients treated at Barnes-Jewish Hospital who received tPA for their ischemic stroke, and those who were considered for endovascular thrombectomy therapy. For more information on these treatments, click here.

Ischemic Stroke Treatment # Cases
tPA Administered at Barnes-Jewish Hospital 97
tPA Administered at Stroke Network Hospital and Transferred to Barnes-Jewish Hospital 124
Endovascular Thrombectomy 81
Total: 302

Ischemic Stroke Treatment


Ischemic Stroke Treatment Outcomes

Intracranial hemorrhage is the major risk of thrombolytic therapy with similar rates reported for both intravenous and intra-arterial routes. The NINDS trial found that 6.4% of patients treated with IV t-PA experienced symptomatic bleeding.

Hemorrhagic Transformation for Patients Treated with tPA or Endovascular Thrombectomy

* Smaller numbers represent better outcomes.

The Thrombolysis in Cerebral Infarction (TICI) scale is a tool used to grade the degree of perfusion obtained following recanalization of an arterial occlusion. Recanalization of an arterial occlusion increases reperfusion into distal segments of the artery and restores blood flow to brain tissue. Scores may range from 0 (no perfusion) to 3 (full perfusion with filling of all distal branches).

Endovascular Thrombectomy Cases with TICI Score of 2b or 3

*Many of our patients are able to go home 48 hours post thrombectomy. These patients are not included in the GWTG data.
**TICI score = Thrombolysis in Cerebral Infarction in Reperfusion Grade


Aneurysm Treatment

For more information on Aneurysm clipping and coiling, click here.

Aneurysm Treatment # Cases
Endovascular Aneurysm Coiling 135
Aneurysm Clipping 42
Total: 177
 

From 2002 through 2014, 769 endovascular (coiling) procedures were performed at Barnes-Jewish Hospital to treat unruptured brain aneurysms. Of those cases, 25 had complications of stroke - a complication rate of 3.25%. Read more →

Aneurysm Treatment


Joint Commission Performance Measures

IV tPA Administered by 3 Hrs. of Onset

IV tPA Administered by Three Hours of Onset

The percentage of patients who received tPA within three hours of onset of their ischemic stroke, if they got to the hospital within two hours of onset of stroke. Higher numbers show greater success at giving tPA to those who need it.

Antithrombotics at Discharge

Antithrombotics at Discharge

The percentage of patients with ischemic stroke receiving antithrombotic therapy at the time of discharge. Patients with ischemic stroke should be on some form of medication to prevent blood clot formation (antithrombotic therapy), to lower the risk of stroke in the future. The medications most often used for this are aspirin, clopidogrel, or aspirin/dipyridamole.

Anticoagulation for Atrial Fibrillation/Flutter

Anticoagulation for Atrial Fibrillation / Flutter

The percentage of patients with ischemic stroke who also have atrial fibrillation (a heart rhythm disturbance) who are discharged on warfarin or other anticoagulation. These are the most effective medications to prevent future ischemic stroke in these patients.

Assessed for Rehabilitation Before Discharge

Assessed for Rehabilitation Before Discharge

The percentage of patients with stroke who are assessed for the need for rehabilitation therapies, either by therapists or physicians. Patients with stroke, whether severe or mild, should be assessed to see if they need physical, occupational, or speech therapy to speed their recovery, so these therapies can be started, if needed, to speed up recovery.

VTE Prophylaxis by Hospital Day 2

VTE Prophylaxis by Hospital Day 2

The percentage of patients receiving treatment to prevent blood clot formation in the legs or lungs by hospital day two. Patients with stroke can develop blood clots in the legs or lungs as a complication (called venous thromboembolism, or VTE), so it's important that they receive treatments to try and prevent these, starting early in their hospitalization.

Statin Prescribed at Discharge for LDL>100

Statin Prescribed at Discharge for LDL>100

It is recommended that patient with ischemic stroke who have LDL cholesterol (the so-called "bad" cholesterol) greater than 100 receive "statin" medications, because this is proven to lower the risk of future stroke and heart attack. This graph displays the percentage of these patients who were discharged on a ‘statin.’

Early Antithrombotics by Day 2

Early Antithrombotics by Day 2

The percentage of patients with ischemic stroke receiving medication to prevent blood clot formation (antithrombotic therapy) by the end of hospital day 2, to lower the risk of stroke in the future. The medications most often used for this are aspirin, clopidogrel, or aspirin/dipyridamole.

Stroke Education

Stroke Education

The percentage of patients with stroke who received education, including education about stroke risk factors, how to recognize stroke, and the importance of calling an ambulance in order to get to the hospital quickly if having a stroke.

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