AHA/ASA Scientific Statement Addresses Five Key Elements to Optimize Treatment of In-Hospital Stroke

February 9, 2022—The American Heart Association/American Stroke Association (AHA/ASA) announced the publication of a scientific statement on optimizing treatment of in-hospital stroke by the writing committee of Chair Ethan U. Cumbler, MD, and Vice-Chair Amre Nouh, MD, et al.

The scientific statement is available online in Stroke and was discussed during a symposium on February 9 at AHA/ASA’s International Stroke Conference 2022 held on February 8-11 both virtually and in New Orleans, Louisiana.

According the AHA/ASA press release, although hospitalized patients are in a monitored environment, the evaluation and treatment of stroke are often delayed compared to patients arriving with a stroke at the emergency department, thereby contributing to higher rates of morbidity and mortality for in-hospital stroke.

The scientific statement outlines five elements for the development of hospital systems of care and targeted quality improvement to reduce delays and optimize treatment to improve outcomes for patients who experience an in-hospital stroke, which affects between 35,000 and 75,000 hospitalized patients annually in the United States.

As outlined in the AHA/ASA press release, the five core elements of the statement are:

• Training all hospital staff on stroke signs, symptoms, and activation protocols for in-hospital stroke alerts
• Creating rapid response teams with dedicated stroke training and immediate access to neurologic expertise
• Standardizing the evaluation of potential in-hospital stroke patients with physical assessment and imaging
• Eliminating and addressing potential treatment barriers including interfacility transfer to advanced stroke treatment
• Establishing an in-hospital stroke quality oversight program delivering data-driven performance feedback and driving targeted quality improvement efforts

Additionally, institutions are encouraged to develop a plan for in-patient stroke response teams that includes education, quality review, and specified oversight.

The scientific statement was developed by the writing committee on behalf of the American Heart Association’s Stroke Council; the Council on Arteriosclerosis, Thrombosis and Vascular Biology; the Council on Cardiovascular and Stroke Nursing; the Council on Clinical Cardiology; and the Council on Lifestyle and Cardiometabolic Health. The committee included experts in nursing, neurology, internal medicine, neurocritical care, neurosurgery, and neurointerventional radiology.

Additionally, the American Academy of Neurology affirms the value of this statement as an educational tool for neurologists, and the American Association of Neurological Surgeons/Congress of Neurological Surgeons Cerebrovascular Section affirms the educational benefit of this statement, advised the AHA/ASA press release.