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Implementation of a Stroke Registry Is Associated with an Improvement in Stroke Performance Measures in a Tertiary Hospital in Mexico

2015; Elsevier BV; Volume: 24; Issue: 4 Linguagem: Inglês

10.1016/j.jstrokecerebrovasdis.2014.09.008

1532-8511

Ana Lucia Herrera, Fernando Góngora‐Rivera, Walter Muruet-Gutierrez, Héctor J. Villarreal, Mildred A Gutierrez-Herrera, Lena Huerta, Diana Carrasco, Anally Soto-García, Meztli Espinosa-Ortega,

Venous Thromboembolism Diagnosis and Management

Background Stroke registries provide a simple way for improving patient care, and its use has been associated with a better adherence to the published guidelines. Few Latin American countries had established stroke registries. Our study is the first in Mexico to report the effects of implementing a stroke registry. To determine if the implementation of a systematized registry is associated with an improved adherence to the performance measures. Methods We compared prospective data (August 2008-November 2010) against historical controls (February 2005-July 2008). Our stroke registry (i-Registro Neurovascular) consists of a standardized clinical form that includes demographic and clinical variables (risk factors, medications, neuroimaging, etiology, acute and outpatient treatments, and neurologic scores [National Institutes of Health Stroke Scale and modified Rankin Scale]). We evaluated 9 performance measures suggested by the American Heart Association and the Joint Commission. Results We analyzed the data from 574 patients, 260 from the prospective phase and 314 from historical controls. No significant statistical differences in demographic characteristics or stroke risk factors were found. The implementation of the stroke registry was associated with a statistically significant (P < .05) improvement in almost all of the acute performance measures. The composite measure also showed an improvement form 52.6%-68.8% (P < .001). Conclusions The implementation of a systematized registry significantly improved our clinical practice. This intervention is a low cost and readily achievable and a viable option for encouraging an increased report of guidelines adherence of other hospitals in Latin America. Stroke registries provide a simple way for improving patient care, and its use has been associated with a better adherence to the published guidelines. Few Latin American countries had established stroke registries. Our study is the first in Mexico to report the effects of implementing a stroke registry. To determine if the implementation of a systematized registry is associated with an improved adherence to the performance measures. We compared prospective data (August 2008-November 2010) against historical controls (February 2005-July 2008). Our stroke registry (i-Registro Neurovascular) consists of a standardized clinical form that includes demographic and clinical variables (risk factors, medications, neuroimaging, etiology, acute and outpatient treatments, and neurologic scores [National Institutes of Health Stroke Scale and modified Rankin Scale]). We evaluated 9 performance measures suggested by the American Heart Association and the Joint Commission. We analyzed the data from 574 patients, 260 from the prospective phase and 314 from historical controls. No significant statistical differences in demographic characteristics or stroke risk factors were found. The implementation of the stroke registry was associated with a statistically significant (P < .05) improvement in almost all of the acute performance measures. The composite measure also showed an improvement form 52.6%-68.8% (P < .001). The implementation of a systematized registry significantly improved our clinical practice. This intervention is a low cost and readily achievable and a viable option for encouraging an increased report of guidelines adherence of other hospitals in Latin America.