The UofL Hospital Stroke Center achieved the highest recognition with the American Heart Association/American Stroke Association, receiving the Get with the Guidelines Stroke Gold Plus Award for the last 14 years. The recognition is awarded for meeting performance guidelines for the treatment and management of stroke patients from hospital admission to discharge.

• Target Stroke  Honor Roll (2012-2016)
• AHA Gold Plus Award (2007-2020)
• Target Stroke Elite Plus Award (2015 - 2021)

At the UofL Hospital Stroke Center, directed by Kerri Remmel, M.D., PhD, we focus on providing care that has been shown to quickly and efficiently treat stroke patients.

To receive the Gold Plus award, University of Louisville Hospital achieved 85 percent or higher adherence to all Get With The Guidelines-Stroke Quality Achievement indicators for two or more consecutive 12-month intervals, and achieved 75 percent or higher compliance with six of 10 Get With The Guidelines-Stroke Quality Measures, reporting initiatives to measure quality of care. 

These measures include aggressive use of medications, such as antithrombotics, anticoagulation therapy, deep vein thrombosis prophylaxis, cholesterol-reducing drugs and smoking cessation, all aimed at reducing death and disability and improving the lives of stroke patients.           

In addition to the Get With The Guidelines-Stroke award, UofL Hospital also has been recognized as a recipient of the association’s Target: Stroke Honor Roll for improving stroke care. Over the past quarter, at least 50 percent of the hospital’s eligible ischemic stroke patients have received tissue plasminogen activator, or Alteplase, within 60 minutes of arriving at the hospital. A thrombolytic, or clot-busting agent, Alteplase is the only drug approved by the U.S. Food and Drug Administration for the urgent treatment of ischemic stroke. If given intravenously in the first three hours after the start of stroke symptoms, Alteplase has been shown to significantly reverse the effects of stroke and reduce permanent disability.

Kentucky is in the Stroke Belt. The Stroke Belt is an 11-state region of the U.S. where studies show the risk of stroke is 34 percent higher for the general population than it is in other areas of the country, and death rates are more than 10 percent higher than the U.S. average. 

According to the American Heart/Stroke Association:

• Stroke is the fifth-leading cause of death and a leading cause of long-term disability
• Stroke is the leading cause of preventable disability
• Approximately 795,000 people in the U.S. have a stroke every year, with about three in four being first-time strokes
• Every four minutes someone dies of a stroke
• More women than men have strokes each year
• African Americans are more impacted by stroke than any other racial group within the American population

Data: U.S. Centers for Disease Control and Prevention

In 2018, 2,204 Kentuckians died of stroke, which represented 1.5 percent of all deaths for that year.  Among all states, Kentucky had the 11th-highest stroke mortality rate in the nation (41.5 deaths per 100,000 population – age adjusted).

Data: Kentucky Office of Vital Statistics

In 2018, 4.5 percent of Kentuckians had been told they have had a stroke. 

Data Source: 2015 KY Behavioral Risk Factor Surveillance System 

Types of Stroke

Stroke is a disease that affects the arteries leading to and within the brain. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts (or ruptures). When that happens, part of the brain cannot get the blood (and oxygen) it needs, causing brain tissue to die.

There are 2 types of stroke:

• Ischemic Stroke: Blockage of blood flow to the brain due to a blood clot or plaque buildup in the arteries. Ischemic Strokes are the most common and represent 87 percent of all strokes.
• Hemorrhagic Stroke: This type of stroke represents 13 percent of all strokes due to bleeding into the brain tissue or subarachnoid space from a ruptured blood vessel.
  • The two types of hemorrhagic strokes are subarachnoid hemorrhage and intracerebral hemorrhage.
    • Subarachnoid hemorrhage (SAH) occurs when a blood vessel on the surface of the brain ruptures and bleeds into the space between the brain and the skull.
    • Intracerebral hemorrhage (ICH) occurs when a blood vessel bleeds into the tissue deep within the brain.

A Transient Ischemic Attack (TIA) is transient symptoms of a stroke caused by temporary blockage of blood flow to the brain, but does not leave permanent damage.  Symptoms usually resolve within a few minutes.  Having a TIA is a medical emergency and increases the risk of having a stroke

Symptoms of a Stroke

Stroke is a medical emergency! Call 911 immediately!

Risk Factors

Some of the most common modifiable risk factors leading to a stroke are:

• High blood pressure (the No. 1 risk factor for all strokes)
• Diabetes
• High cholesterol
• Tobacco abuse
• Atrial fibrillation
• Physical inactivity and obesity
• Carotid artery disease
• Sleep apnea
• TIA
• Excessive alcohol abuse
• Illegal drug use

What is Public Reporting?

Public Reporting is Information that is readily available to the public regarding a health care organization’s quality and safety of care. It can help organizations improve their services, but more importantly, this information may also help educate consumers and health care purchasers in making informed choices about their health care and the procedures performed

What are Stroke Core Measures or Quality Reports?

The Joint Commission is an organization that accredits hospitals and health care organizations across the country.  They seek to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. Stroke quality measure reports provide an overview of how well an accredited organization or certified program are performing with stroke-specific Joint Commission requirements and standards.

What is/are GWTG?

Get With The Guidelines (GWTG)-Stroke® (GWTG-S) was developed by the American Heart Association/American Stroke Association (AHA/ASA) as a national stroke registry and performance improvement program.  The primary goal of the GWTG-S® registry is to improve the quality of care and outcomes for patients hospitalized with stroke and transient ischemic attack (TIA). The GWTG-S® registry helps achieve this goal in a variety of ways, allowing hospitals to benchmark themselves against other like facilities, stroke research, promoting stroke center certification, supporting hospital level quality improvement initiatives, and supporting the development, growth, and monitoring of regional stroke systems of care.

The below procedures are commonly performed in the diagnosis, prevention, and/or treatment of stroke. 

Table 1: Representation of the Complication Rate for each procedure at University of Louisville Hospital (in red) and the National Benchmark Goal (white column labeled National Goal).

Helpful Definitions

Complication Rate: The complication rates are a percentage representing the number of patients experiencing complications related to the procedure that they had performed. 

Carotid Stent: A procedure where a flexible, metallic type, tube shaped mesh, called a stent, is implanted into the carotid artery via your upper thigh/groin area to help support the vessel walls, keeping the artery open for blood to flow more regularly. These procedures are often performed by neuro-interventionalists, interventional cardiologists, and/or vascular surgeons in a radiology suite with special imaging equipment.

Carotid Endarterectomy (CEA): A surgery to remove the fat buildup (plaque) or cholesterol deposits that are creating narrowing and blockages of your carotid arteries. This is performed by a surgeon in the operating room.

Diagnostic Angiogram: An invasive imaging procedure that provides high-definition visualization of the blood vessels of your brain or neck. Sometimes the angiogram is done as a diagnostic tool to look at the blood vessels to see if there are any abnormalities. This is called a diagnostic angiogram.

Endovascular Thrombectomy (EVT):
In acute stroke patients with a large vessel occlusion (LVO), it is appropriate in some patients for an invasive procedure to be performed to retrieve the clot. This is called endovascular therapy or EVT. This may also be referred to as mechanical thrombectomy by some providers. During this procedure, a physician places a catheter through a blood vessel (artery) in the arm or leg directly up to the blood vessel in the brain where the clot is blocking blood flow to brain tissue. The clot is then removed by inserting a device into the blood clot and pulling the clot out (see pictures below). The AHA/ASA nationally recommended hospital time goal for this procedure is retrieving the blood clot from the blocked blood vessel within 120 minutes of patient arrival to the hospital.

Katie Brooks, Stroke Survivor

Philip Campbell, Stroke Survivor

Stroke Survivor and Caregiver Support Groups

UofL Health stroke care doesn’t end when you leave one of our hospitals. Many stroke survivors and their caregivers experience a range of emotions as they adjust back to normal daily activities. Our stroke team is here to help. Join us for our FREE support groups where you can enjoy talking openly with others who share similar experiences.

UofL Health – Stroke - Louisville Stroke Support Group
Location & Time: Virtually online and/or Crescent Hill Library, 2762 Frankfort Avenue, Louisville, KY 40206
Third Friday of the month
12 p.m. – 2 p.m.
Confirm Location Details and RSVP: Carrie Crockett, CSW at 502-645-5425

UofL Health – Stroke – Campbellsville Stroke Support Group
Location & Time: Virtually online and/or Taylor Co Public Library, 1316 E Broadway Street, Campbellsville, KY 42718
First Friday of the month
1 p.m. – 3 p.m.
Confirm Location Details and RSVP: Carrie Crockett, CSW at 502-645-5425

UofL Health – Stroke and Memorial Hospital Stroke Support Group
Location & Time: Virtually online and/or Medical Arts Conference Room (lower level of Medical Arts Building)
721 W. 13 Street
Jasper, IN 47546
Fourth Tuesday of the month
1 p.m. – 3 p.m.
Confirm Location Details and RSVP: Mary Jo Eaton Calhoun, BSN, RN at 812-996-6364
Carrie Crockett, CSW at 502-645-5425

UofL Health – Mary & Elizabeth Hospital – Stroke Support Group
Location & Time: UofL Health – Mary & Elizabeth Hospital, Churchman Conference Room, First Floor Medical Plaza 1, 4402 Churchman Avenue, Louisville, KY 40215
Second Wednesday of the month
12 p.m. – 2 p.m.
Confirm Details and RSVP: Stephanie Metzroth or Jennifer Bucher at 502-361-6585

UofL Health – Stroke Virtual Stroke Support Group
Virtually online via Zoom
Fourth Wednesday of the month
6 p.m. – 7 p.m.
Contact: Carrie Crockett, CSW at 502-645-5425

 

UofL Health – Stroke – Facebook Support Group
facebook.com/groups/uoflhealthstrokesupport/

Jason Stiles MSN, RN, CEN, System Director, Stroke
Phone: 502-333-6962
E-mail: jason.stiles@uoflhealth.org

Judy Bullard, Stroke Center Program Assistant
Phone: 502-562-8009
E-mail: judy.bullard@uoflhealth.org

Carrie Crockett, CSW Stroke Social Worker
Phone: 502-645-5425
E-mail: carrie.crockett@uoflhealth.org