TY - T1的改善临床结果在医疗保险受益人急性缺血性中风的初始实现得到Guidelines-Stroke计划2003 - 2008 (S19.003) JF -神经学乔-神经病学SP - S19.003 LP - S19.003六世- 78 - 1补充AU -萨拉歌AU - Gregg Fonarow盟嵚锅盟大和总研奥尔森AU -阿德里安·埃尔南德斯盟-埃里克·皮特森盟-马修Reeves首页 AU -埃里克史密斯盟-李Schwamm盟-杰弗里节省Y1 - 2012/04/24 UR - //www.ez-admanager.com/content/78/1_Supplement/S19.003.abstract N2 -目的:研究观察临床中风的结果之前和之后医院软件质量计划的实施。背景21世纪的第一个十年变化在急性缺血性中风保健,包括更多地使用IV rt-PA和正式组织中风中心。从急性缺血性中风的临床结果的变化在这段时间内没有完全描述。设计/方法:我们分析了缺血性中风患者的临床结果的医院加入得到Guidelines-Stroke (GWTG-Stroke)从4月1日,2003年到2008年12月12日通过国家医疗保险数据集。我们指定三个时间段:pre (GWTG-Stroke参与前6个月),(GWTG-Stroke参与的前6个月),早期和晚期(GWTG-Stroke 6 - 18个月后实施)。分析结果包括出院回家;住院,30天,1年死亡率;30天,1年再入院治疗中风、心血管事件,所有的原因。结果:139293名患者从725年网站分析了平均年龄79.5岁,41%为男性,84%是白人。病人人口跨时间段是相似的。Statistically significant changes between pre and late periods included: reduced mortality at 30 days (15.3% vs. 13.0%, p<.0001) and 1 year (28.0% vs 25.5%, p<.0001), reduced stroke/TIA rehospitalization at 30 days (3.1% vs. 2.4%, p<.0001) and 1 year (9.2% vs. 8.7%, p<.002), reduced rehospitalization for cardiovascular event at 30 days (2.9% vs. 2.3%, p<.0001) and 1 year (15.9% vs. 13.5%, p<.0001), and reduced all cause rehospitalization at 30 days (17.4% vs. 15.1%, p<.0001) and 1 year (55.8% vs. 53.0%, p<.0001).Conclusions: During the first 2 years of participation, clinical outcomes for Medicare beneficiaries with acute ischemic stroke among hospitals joining GWTG-Stroke improved substantially, with 15% lower 30 day mortality rates and 24% lower 30 day rehospitalization rates for stroke or TIA. Further study is planned to determine if similar improvements in outcomes occurred at non-participating hospitals during this time frame.Disclosure: Dr. Song has nothing to disclose. Dr. Fonarow has received personal compensation for activities with UCLA, National Institutes of Health, Pfizer Inc, Medtronic, Inc., and Novartis. Dr. Fonarow has received royalty payments from UCLA. Dr. Fonarow has received research support from the National Institutes of Health. Dr. Pan has nothing to disclose. Dr. Olson has nothing to disclose. Dr. Hernandez has nothing to disclose. Dr. Peterson has received research support from Bristol Myers Squibb/Sanofi Aventis Partnership. Dr. Reeves has nothing to disclose. Dr. Smith has received personal compensation for activities with Genentech, Inc. as an advisory board member. Dr. Schwamm has received personal compensation for activities with CoAxia, Inc., Phreesia, RTI Health Solutions, and CryoCath as a medical advisory board member. Dr. Schwamm has received research support from Bristol-Myers Squibb-Sanofi. Dr. Saver has received personal compensation for activities with BrainsGate, CoAxia, ev3, Talecris, PhotoThera, and Sygnis. Dr. Saver has received research support from the NIH, ev3, and Concentric.Tuesday, April 24 2012, 15:00 pm-16:30 pm ER -