Abstract TP124: Evaluating Secondary Stroke Prevention Following Discharge From a Community Hospital

Abstract

Background: Having major effects on both morbidity and mortality, stroke has become a large health burden worldwide. This disease state not only is the second leading cause of death; but also leaves about half of survivors chronically disabled. The 2021 AHA guidelines state that the risk of a recurrent stroke can be mitigated with appropriate secondary stroke prevention. The success of these interventions following discharge from the hospital largely lies in the hands of both the primary care physician and the patient. The goal of this investigation is to determine patient and provider compliance with risk factor modification and drug therapy within 3 months of hospitalization for acute ischemic stroke or transient ischemic attack. Methods: This quality improvement project is a single-center, retrospective chart review of the current secondary stroke prevention procedures exercised at a community hospital within a large healthcare system. This project has received Institutional Review Board approval. To be included, subject were required to have established primary care within the health system, discharged home following admission, and a final principle diagnosis of acute ischemic or transient ischemic event. The primary outcome assessed the percentage of patients that received a follow-up visit with a primary care provider within 30 days of hospital discharge. Additionally, this investigation also assessed modifiable risk factor management for secondary ischemic stroke prophylaxis. Results: Of the 97 patients that met inclusion criteria, 49 of them received a follow-up visit with a primary care provider within 30 days of hospital discharge (50.5%). In regards to secondary outcomes, all outcomes assessed showed to achieve appropriate clinical follow-up except for management of hypertension. It was reported that of the 49 patients, twenty-seven were reported to have controlled blood pressure at follow-up (55%). Conclusions: Results from the primary outcome of this quality improvement project highlighted the need for additional intervention to establish primary care prior to hospital discharge. Additionally this evaluation also highlighted further need for management of hypertension as a modifiable secondary risk factor.