The Number of Patients Admitted with Stroke in 2021
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.
Definitions:
Ischemic Stroke: Stroke caused by an obstruction within a blood vessel supplying blood to the brain. Read more →
Intracerebral Hemorrhage: Blood leakage inside the brain caused when a diseased blood vessel within the brain weakens or leaks.
Subarachnoid Hemorrhage: Bleeding outside the brain, usually from the rupture of a brain aneurysm.
TIA: Abbreviation for transient ischemic attack. A temporary episode of stroke symptoms, which go away completely in less than 24 hours. Caused by temporary decreased blood flow to part of the brain. Read more →
Definitions:
Aneurysm: A weak spot in a blood vessel, which may burst, causing a subarachnoid hemorrhage. Read more →
AVM: Arteriovenous malformation, a collection of abnormal veins and arteries, which may bleed, causing intracerebral or subarachnoid hemorrhage. Read more →
Moyamoya: Progressive narrowing of the larger vessels at the base of the brain. Can lead to ischemic stroke or intracerebral hemorrhage. Read more →
Types of Stroke
For an explanation of the types of stroke, click here.
| Types of Stroke |
# Cases |
| Ischemic Stroke |
791 |
| Intracerebral Hemorrhage |
252 |
| Subarachnoid Hemorrhage |
109 |
| TIA |
110 |
| Total: |
1,262 |
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.
Definitions:
tPA Administered in BJH ED: tPA is a clot-busting drug used to dissolve the blockage in a blood vessel that is causing an ischemic stroke, to restore blood flow, and help prevent disability after a stroke.
Definitions:
Endovascular Thrombectomy: Minimally invasive (catheter-based) angiography procedure to treat stroke by mechanically retrieving a blood clot.
Endovascular Thrombectomy Therapy: a procedure where a blockage in a blood vessel is removed by a catheter inserted into the blocked artery.
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.
* 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).
*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.
Definitions:
Endovascular Coiling: A procedure where an angiogram is performed, and a catheter is used to place multiple small soft coils directly into the aneurysm to fill the space and prevent bleeding.
Definitions:
Aneurysm Clipping: Surgical procedure in which a clip is placed at the base of the aneurysm to prevent it from rupturing.
From 2002 through 2020, more than 2,000 endovascular (coiling) procedures were performed at Barnes-Jewish Hospital to treat unruptured brain aneurysms. Of those cases, 67 had complications of stroke - a complication rate of 3.97%. Read more →
Joint Commission Performance Measures
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.
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.
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.
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.
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.
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.’
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.
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.