Related Experiment Video
Updated: Dec 5, 2025
PIPEMAT-RS: Development and Validation of a Standardized MATLAB Pipeline for Resting-State EEG Preprocessing
Published on: June 6, 2025
Adherence to American Heart Association/American Stroke Association Clinical Performance Measures in a Peruvian
Carlos Abanto1, Angela K Ulrich2, Ana Valencia1
1Instituto Nacional de Ciencias Neurológicas, Departamento de Enfermedades Neurovasculares, Jirón Ancash 1271, Barrios Altos, Lima 01, Peru.
Insights
Adherence to American Heart Association/American Stroke Association (AHA/ASA) stroke performance measures in Peru was 47%. Factors like marital status and symptom onset time influenced adherence, suggesting a need for targeted interventions to improve stroke care outcomes.
Area of Science:
- Neurology
- Public Health
- Healthcare Quality Improvement
Background:
- Adherence to American Heart Association/American Stroke Association (AHA/ASA) stroke performance measures is not well-documented in developing nations.
- Peru, a developing country, lacks data on the implementation of these critical stroke care standards.
Purpose of the Study:
- To evaluate adherence to AHA/ASA stroke performance measures in Peru.
- To identify factors associated with adherence to these measures at a leading neurological center.
Main Methods:
- Retrospective review of 150 stroke patient charts from 2014-2016.
- Assessment of adherence to 15 distinct AHA/ASA stroke performance measures using simple and composite metrics.
- Analysis of associations using nonparametric statistics and multivariate logistic regression.
Main Results:
- Mean adherence to AHA/ASA stroke performance measures was 47%.
- Being married was associated with higher adherence to ischemic stroke measures (OR=3.78).
- Symptom onset >4.5 hours before arrival (OR=0.14) and higher NIHSS scores (OR=0.11) were linked to lower adherence.
Conclusions:
- Adherence to international stroke care standards in this Peruvian institution fell short of AHA/ASA achievement benchmarks.
- Interventions focusing on stroke prevention education and enhanced clinical training are recommended to improve patient outcomes in Peru.
Background:
Little is known about adherence to American Heart Association/American Stroke Association (AHA/ASA) stroke performance measures in developing countries like Peru.
Aims:
We assessed adherence and determined factors associated with adherence to the AHA/ASA stroke performance measures at a reference center for neurological diseases in Lima, Peru.
Methods:
We conducted a retrospective chart review of 150 stroke patients admitted to the Neurological Institute of Neurological Science from 2014 to 2016 to ascertain adherence to 15 different AHA/ASA stroke performance measures. Adherence was measured as a simple proportion, with both single and composite measures. Associations were analyzed with nonparametric statistics and multivariate logistic regression.
Results:
Mean adherence to AHA/ASA stroke performance measures was 47%. We observed a statistically significant relationship between adherence to ischemic stroke performance measures and being married (OR = 3.78, 95% CI: 1.05-13.55), as well as an inverse relationship with an onset of symptoms of greater than 4.5 h prior to arrival at the hospital compared to those with ≤ 4.5 h (OR = 0.14, 95% CI: 0.02-0.97). Compared to patients with a lower National Institutes of Health Stroke Scale (NIHSS) score (<13), those with a score of ≥13 were less likely to have good adherence (OR = 0.11, 95% CI: 0.04-0.31).
Conclusions:
The mean composite measure of adherence to internationally recognized standards of stroke management in our Peruvian institution was below the level needed for an achievement award by AHA/ASA. An intervention targeted toward stroke prevention and training could lead to improved outcomes of stroke patients in Peru.
