Processes of Care Associated With Risk of Mortality and Recurrent Stroke Among Patients With Transient Ischemic Attack and Nonsevere Ischemic Stroke | Zendy

Dawn M. Bravata | Zendy; Laura J. Myers | Zendy; Mathew J. Reeves | Zendy; Eric M. Cheng | Zendy; Fitsum Baye | Zendy; Susan Ofner | Zendy; Edward J. Miech | Zendy; Teresa M. Damush | Zendy; Jason J. Sico | Zendy; Alan J. Zillich | Zendy; Michael Phipps | Zendy; Linda S. Williams | Zendy; Seemant Chaturvedi | Zendy; Jason M. Johanning | Zendy; Zhangsheng Yu | Zendy; Anthony J. Perkins | Zendy; Ying Zhang | Zendy; Greg Arling | Zendy

Open Access

Processes of Care Associated With Risk of Mortality and Recurrent Stroke Among Patients With Transient Ischemic Attack and Nonsevere Ischemic Stroke

Author(s) -

Dawn M. Bravata,

Laura J. Myers,

Mathew J. Reeves,

Eric M. Cheng,

Fitsum Baye,

Susan Ofner,

Edward J. Miech,

Teresa M. Damush,

Jason J. Sico,

Alan J. Zillich,

Michael Phipps,

Linda S. Williams,

Seemant Chaturvedi,

Jason M. Johanning,

Zhangsheng Yu,

Anthony J. Perkins,

Ying Zhang,

Greg Arling

Publication year - 2019

Publication title -

jama network open

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 3.278

H-Index - 39

ISSN - 2574-3805

DOI - 10.1001/jamanetworkopen.2019.6716

Subject(s) - medicine , stroke (engine) , atrial fibrillation , guideline , retrospective cohort study , ischemic stroke , cohort , emergency department , logistic regression , odds ratio , emergency medicine , cardiology , ischemia , pathology , psychiatry , mechanical engineering , engineering

Key Points Question Which processes of care are associated with reduced risk of mortality or recurrent stroke after transient ischemic attack or nonsevere ischemic stroke? Findings In this cohort study of 8076 patients with transient ischemic attack or nonsevere ischemic stroke, only 1216 (15.3%) received without-fail care, defined as receiving all guideline-concordant processes of care for which they were eligible (ie, brain imaging, carotid artery imaging, antihypertensive intensification, high- or moderate-potency statin therapy, antithrombotics, and anticoagulation for atrial fibrillation). Receiving all 6 processes was associated with lower risk of death (31.2% reduction at 1 year) but not lower risk of recurrent stroke. Meaning Clinicians should ensure that patients with transient ischemic attack and nonsevere ischemic stroke receive all guideline-concordant processes of care for which they are eligible.

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