Mission Hospital's code stroke team: implications for an aging population

Area of Science:

• Neurology
• Emergency Medicine
• Public Health

Background:

• Acute ischemic stroke requires rapid evaluation and treatment.
• Stroke intervention programs aim to improve patient outcomes.
• Age is a significant factor in stroke treatment decisions and outcomes.

Purpose of the Study:

• To assess the effectiveness of an acute stroke program.
• To evaluate the risk of symptomatic intracerebral hemorrhage in treated stroke patients.
• To analyze discharge disposition based on age for patients receiving acute stroke intervention.

Main Methods:

• Retrospective review of 568 code stroke evaluations from January 2006 to October 2007.
• Data sourced from Mission Hospital's database and the "Get With the Guidelines" (GWTG) database.
• Analysis of patients treated with acute intervention, comparing outcomes between age groups (≤79 and ≥80 years).

Main Results:

• 27.1% of code stroke patients received acute intervention, primarily intravenous thrombolysis.
• Older patients (≥80 years) had less favorable discharge dispositions and higher in-hospital mortality rates.
• Symptomatic intracerebral hemorrhage occurred in 1.3% of treated patients, with no increased risk observed in older adults.

Conclusions:

• The Code Stroke Team enhanced the proportion of patients receiving acute stroke intervention.
• Aggressive stroke treatment, including thrombolytic therapy, is safe for patients over 80 regarding intracerebral hemorrhage.
• Age-stratified analysis is crucial for understanding treatment impacts on discharge disposition and mortality.