Preventing Recurrent Strokes at Parker Adventist Hospital
Positive outcomes for stroke patients depend not just on emergency intervention but also on comprehensive follow-up care. Parker Adventist Hospital's Stroke Program provides inpatient and outpatient rehabilitation services. Half of all stroke victims will suffer another stroke or a heart attack in four years if steps are not taken to decrease their risk for recurrent strokes. After a stroke, Parker Adventist Hospital's team follows The Joint Commission's 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.
- 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 within 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 with TIAs.