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.
|Original language||English (US)|
|Journal||Journal of Stroke and Cerebrovascular Diseases|
|State||Published - Nov 2020|
Bibliographical noteFunding Information:
Grant support: Research reported in this publication was supported by the Fogarty International Center of the National Institutes of Health under Award Number D43 TW009137
© 2020 Elsevier Inc.
- Adherence to AHA/ASA measures
- Clinical performance measures
- Ischemic stroke
- Stroke performance measures
- United States
- Middle Aged
- Practice Patterns, Physicians'/standards
- Brain Ischemia/diagnosis
- Quality Indicators, Health Care/standards
- Young Adult
- Outcome and Process Assessment, Health Care/standards
- Retrospective Studies
- Treatment Outcome
- American Heart Association
- Guideline Adherence/standards
- Practice Guidelines as Topic/standards
- Developing Countries
PubMed: MeSH publication types
- Journal Article