Emory Report
February 14, 2005
Volume 57, Number 19


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February 14, 2005
Two-year Grady study tracks post-hospital stroke recovery

BY Alicia sands lurry

How well a patient recovers after having a stroke is directly linked to the quality of medical care he or she receives after leaving the hospital, according to Michael Frankel, professor and chief of neurology at Grady Hospital. Now, thanks to a $500,000 grant from the Association of American Medical Colleges (AAMC) and the CDC, Frankel and other researchers soon will learn more about recovery for stroke patients, their quality of life and ways to improve outcomes after hospitalization.

Stroke, as defined by the American Stroke Association (ASA), occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain cannot get the blood (and oxygen) it needs, so it begins to die.

The two-year, AAMC/CDC grant is designed to study stroke outcomes, track information and improve quality of life for stroke survivors. Based at Grady, the project will focus on collecting data to help improve quality of care for study participants. Overall, Frankel hopes hospitals across the country will use a newly developed online tool to improve care for patients after stroke discharge.

“This is a groundbreaking study because no one has ever created a prototype tool for data collection to improve the quality of stroke care after hospital discharge,” said Frankel, the project’s principal investigator. “This project is focused on post-hospital care, including inpatient rehabilitation, medical care, functional recovery, medication adherence, and quality of life and survival.”

Frankel hopes to enroll 1,000 patients, who will be followed for one year through telephone calls and office visits. Along with Grady, University Hospital in Augusta and Candler and St. Joseph’s hospitals in Savannah will participate by identifying stroke patients and enrolling them in the study. The goal is for all four hospitals, which represent approximately 10 percent of the stroke-patient population throughout the state, to contribute to the same database and create quality improvements.

“One of the other aspects we’re going to focus on is whether there are racial differences in stroke outcomes,” Frankel added. “We will look at racial and socioeconomic differences in outcomes; we hope to learn more about why those differences exist, so we can improve the care in communities disproportionately affected by stroke.” Frankel hopes, with more frequent contact after discharge, patients will learn to adhere to medical therapy and follow up with their physicians through clinical appointments.

“We realize that there is a continuum of care that goes beyond the hospital period,” he said. “This project is the first attempt at linking what happened in the hospital with what happens after patients are
discharged to assure good continity and quality of care.”

According to the ASA, stroke is the nation’s No. 3 killer and a leading cause of severe, long-term disability. Every 45 seconds, someone in America has a stroke, and the ASA estimates that approximately 700,000 Americans will have a stroke this year.