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Frequency and determinants of lipid testing in ischemic stroke and transient ischemic attack: findings from get with

Eric E Smith1, Wenqin Pan, DaiWai Olson

  • 1Calgary Stroke Program, University of Calgary, Alberta, Canada. eesmith@ucalgary.ca

Stroke
|December 26, 2009
PubMed

Insights

Lipid testing for stroke patients increased significantly with quality improvement programs. Despite improvements, disparities in low-density lipoprotein (LDL) testing persist, though results often guide treatment.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Public Health

Background:

  • National guidelines advocate for lipid testing in patients experiencing ischemic stroke or transient ischemic attack.
  • This study investigates the prevalence and predictors of in-hospital low-density lipoprotein (LDL) testing.

Purpose of the Study:

  • To assess the trends and influencing factors of LDL testing in hospitalized stroke patients.
  • To identify patient and hospital characteristics associated with lipid testing adherence.

Main Methods:

  • Utilized data from 981 Get With The Guideline-Stroke (GWTG-Stroke) hospitals between 2003 and 2008.
  • Analyzed 479,284 consecutive ischemic stroke or transient ischemic attack admissions.
  • Employed logistic regression models to identify predictors of LDL testing.

Main Results:

  • The frequency of LDL measurement rose from 54.3% in 2003 to 81.9% in 2008.
  • Increased participation in GWTG-Stroke was associated with higher LDL testing rates.
  • Testing was less frequent in women, nonsmokers, and patients with atrial fibrillation or prior stroke/TIA.

Conclusions:

  • Significant improvements in LDL measurement rates were observed within a large quality improvement initiative.
  • Despite progress, disparities in LDL testing among stroke patients remain.
  • LDL testing frequently identified levels that warranted adjustments in clinical management.
Abstract

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