Lege Artis Medicinae

[Secondary prevention following ischemic stroke - A documentational process audit]

TÖRÖK Miklós, MIHÁLKA László, RÁCZ Sándor, FEKETE István, CSIBA László, BERECZKI Dániel

FEBRUARY 20, 2003

Lege Artis Medicinae - 2003;13(02)

[INTRODUCTION - A previous stroke or a transient ischemic attack is an important risk factor for stroke, therefore measures for secondary prevention have great importance. Based on the results of multicenter randomized controlled trials guidelines for medical and surgical methods for secondary stroke prevention have been established in the last years. In our study - that can be considered a documentational process audit - we analyzed whether there was a change in the past 5 years in the documented recommendations for secondary stroke prevention in the discharge reports of patients with ischemic stroke. PATIENTS AND METHODS - The periods of examination were the first 3 months of 1995 and 2000. We reviewed the discharge reports of all patients discharged from the stroke unit with the diagnosis of ischemic stroke. We tabulated the history, the results of examinations, the condition of the patients at discharge, the stroke subtype, the indications and contraindications for antiplatelet and anticoagulant treatment and of carotid endarterectomy, and the recommended measure for secondary stroke prevention as documented in the discharge report. Data of 205 patients were analyzed. RESULTS - For the majority of patients medical treatment was recommended for secondary prevention. Only 5 patients were candidates for carotid endarterectomy. CONCLUSIONS - The documented practice of secondary stroke prevention significantly improved between 1995 and 2000: the recommendation of internationally accepted guidelines based on the results of randomized controlled trials are reflected better in the discharge reports of patients treated in 2000 (p = 0,0013).]

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