Recurrent Stroke Prevention at St. Anthony Hospital
Recurrence of stroke is common. After a stroke, the stroke team at St. Anthony Hospital follows The Joint Commission clinical performance measures to prevent another stroke including:
- Discharging patient with antithrombotics - the patient is discharged with medication that prevents the formation of blood clots.
- Patients with atrial fibrillation receive anticoagulation therapy - about 15 percent of strokes occur in people with atrial fibrillation (abnormal heart rhythm). During atrial fibrillation, the atria (two upper chambers of the heart) quiver instead of beating normally. Blood does not pump completely out of the atria and may pool and clot. If a piece of a blood clot leaves the heart and becomes lodged in a brain artery, a stroke results. Anticoagulation therapy involves prescribing blood thinning medication that prevents the formation of blood clots.
- Lipid profile - an elevated serum lipid level is a risk factor for coronary artery disease. Elevated lipid levels are also related to the incidence of stroke. The reduction of LDL cholesterol, through lifestyle modification and medication, for the prevention of stroke and other vascular events is recommended for patients with coronary artery disease. A lipid profile blood test is recommended for all stroke patients. A lipid profile usually includes total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and low-density lipoprotein (LDL) cholesterol.
- Stroke education - providing education about stroke for patients and care providers
- Smoking cessation - smoking is a serious risk factor for a stroke. Before discharge, stroke patients who smoke receive counseling and information on ways to quit smoking. St. Anthony Central Hospital also offers a individualized smoking cessation program with a certified addiction counselor, learn more and schedule an appointment...
- Antithrombotic medication within 48 hours of hospitalization - patients recovering from a mild stroke or who have had a recent transient ischemic attack (TIA or "mini" stroke) are at high risk of having another stroke. Antithrombotic drugs, which prevent the formation of blood clots, should be given with 48 hours of symptom onset in acute ischemic stroke patients who meet certain guidelines for these drugs. Antiplatelet therapy is also recommended for most patients w/TIAs.
- Tissue plasminogen activator (tPA) considered - tPA is a clot-dissolving drug approved by the FDA to treat ischemic stroke (blood clots in the brain) in the first three hours after the start of symptoms. The sooner tPA or other appropriate treatment is begun, the better the chances for recovery.
Measures to Prevent Complications
- DVT prophylaxis (prevention of leg vein blood clots) - deep vein thrombosis (DVT) involves the formation of a clot in the veins in the lower leg and the thigh. This clot may interfere with circulation and may break off and travel through the blood vessels and cause another stroke. Patients experiencing stroke that involves a partially or totally paralyzed leg are at increased risk of developing DVT. DVT prevention is recommended for at-risk patients to reduce the risk of another stroke. Preventive measures include the use of blood thinning medications, compression stockings and pneumatic (air) compression of the legs.
- Screen for dysphagia - a stroke can affect many body functions, including the ability to swallow. Stroke patients are at particular risk of aspiration (choking) because of dysphagia (difficulty swallowing). All stroke patients should be checked for their ability to swallow.
- Rehabilitation plan considered - before discharge, stroke patients should be assessed and receive rehabilitation services to enhance their recovery and minimize functional disabilities.