Association Between Adherence to Quality Indicators and 7-Day In-Hospital Mortality After Acute Ischemic Stroke.

Area of Science:

• Neurology
• Healthcare Quality
• Public Health

Background:

• Quality indicators (QI) are vital for assessing hospital performance in routine care.
• Acute stroke care quality is crucial for patient outcomes.

Purpose of the Study:

• To investigate the association between adherence to evidence-based quality indicators (QI) and early outcomes in German acute stroke care.
• To determine if higher adherence to stroke care QI correlates with reduced in-hospital mortality.

Main Methods:

• Analysis of ischemic stroke patients from the German Stroke Register Study Group (ADSR) network (736 hospitals).
• Assessment of adherence to 11 evidence-based early stroke care QI.
• Generalized linear mixed model analysis correlating QI adherence with 7-day in-hospital mortality, adjusted for patient and hospital factors.

Main Results:

• 388,012 ischemic stroke patients analyzed (2015-2016).
• Adherence to QI varied (41.0% for thrombolysis to 95.2% for physiotherapy).
• A significant linear association was found: higher QI adherence correlated with lower 7-day in-hospital mortality (OR <50% vs. 100% adherence: 12.7).

Conclusions:

• Higher quality of acute stroke care, measured by adherence to evidence-based process QI, is associated with lower in-hospital mortality.
• Implementing and adhering to stroke care QI is critical for improving patient survival rates.