CPMC Stroke Care Outcomes

California Pacific Medical Center stands at the forefront of treating stroke and neurovascular disorders.

Our Comprehensive Stroke Care Center provides advanced neurovascular and neurocritical care and rehabilitation from highly trained stroke specialists, increasing your chances of a full recovery.

Our stroke center was awarded the American Heart Association/American Stroke Association Get With The Guidelines Gold Plus Achievement Award, which ensures you receive treatment according to nationally accepted standards and recommendations. The data below highlights our excellent outcomes, including thrombolysis (TNK) treatment administration and stroke education statistics.

tPA Times

Ischemic Stroke Patients Treated TNK (Tenecteplase)

Door to IV TNK for symptoms < 4.5 hours Non-Complex Patients Median Time (minutes) (less is better)
Goal: Door to TNK in less than 45 minutes:
For 2023 we are at 100% for 45 minutes and 80% of those patients received it in under 30 minutes!!

What are we measuring?

The percentage of patients with ischemic strokes (when blood supply to the brain is blocked) arriving at the emergency room who are able to receive TNK (clot dissolving medication) to potentially reverse the effects of an acute stroke.

Why is this important?

TNK is a "clot-busting" medication that can potentially reverse the symptoms and effects of ischemic strokes. It must be given within the first 4.5 hours of the start of symptoms. Because of this narrow window of time and the unavailability of acute stroke management services, the nationwide average for this treatment is less than 5%.

Neurointerventional capabilities

We offer a full range of advanced Neurointerventional capabilities and other services including:

• Advanced imaging technology to quickly and accurately diagnose a stroke and determine the best treatment approach.
• Comprehensive surgical brain care including the latest interventional neuroradiology treatments, including stent retrievers that grasp blood clots and suction them out while a stroke is in progress.

At CPMC we pride ourselves on offering these services to all eligible ischemic stroke patients. Our physicians will often take patients for immediate lifesaving intervention that may not be treated for at other facilities. For 2021-2022 our team took 100% of eligible patients to the Neuro Interventional Suite for treatment, whereas comparing to all hospitals within California the rate is 98.7%.

When a stroke is happening due to a blood vessel being blocked, the goal of emergent treatment is to restore blood flow to the brain. A Neurointerventional specialist performs a procedure called a thrombectomy to remove the clot and restore blood flow to the brain. In 2021 and 2022, CPMC restored blood flow for patients presenting with large clotting strokes at a higher rate than other hospitals.

         CPMC restores blood flow: 89.1%
         Benchmark: 81.5% for California Hospitals
         Source: Quintiles Stroke Registry, 2021-2022

In December of 2022 our Neuro Interventional team celebrated completing their 1000 case. The patient came to CPMC severely disabled. In the words of the patient: “It was the most extraordinary thing,” Martin says about the experience of going into surgery thinking he might be left severely disabled or even die. “I woke up with no signs anything had happened other than a bandage near my groin where doctors had accessed the femoral artery to snake a catheter up through my body and my brain to perform the thrombectomy.”

Performance Measures

California Pacific’s Comprehensive Stroke Care Center is a certified Primary Stroke Center receiving certification from The Joint Commission. The Joint Commission's stroke (STK) measures were developed in collaboration with the American Heart Association (AHA)/American Stroke Association (ASA)/Brain Attack Coalition (BAC) for use by Disease-Specific Care (DSC)-certified primary stroke centers.

Note: A higher percentage is better.

• What are we measuring?
  • The percentage of patients with ischemic or hemorrhagic stroke that received preventative measures to avoid blood clots forming in their legs (deep vein thrombosis).
• Why is this important?
  • Patients who suffer strokes and do not move or walk around are at risk for developing blood clots in their legs.  This measure looks at our efforts to reduce that risk.

Discharge on Anticoagulation for Patients with Atrial Fibrillation

• What are we measuring?
  • The percentage of ischemic stroke patients with atrial fibrillation that left the hospital on anticoagulation therapy.
• Why is this important?
  • Atrial fibrillation is a common arrhythmia (irregular heartbeat) and is one of the leading causes of stroke. Studies have shown that the risk of stroke was lowered by 68% for atrial fibrillation patients treated with warfarin ("blood thinner" medication). Warfarin and other "blood thinner" medications are effective in preventing strokes from occurring again.

IV TNK Within 3 Hours of Symptom Onset

• What are we measuring?
  • The percentage of ischemic stroke patients who arrive at the hospital within 2 hours of the first symptoms of stroke, and who are given IV TNK within 3 hours of the first symptoms.
• Why is this important?
  • TNK is the "clot-busting" drug that can potentially reverse the effects of a major stroke. It must be given within 3 hours of the start of symptoms to be most effective.

Antithrombotics by Day 2

• What are we measuring?
  • The percentage of ischemic stroke patients given antithrombotics by the end of their second day in the hospital.
• Why is this important?
  • Studies have suggested that antithrombotics (medications that reduce the formation of blood clots) should be given within 48 hours of the first symptoms of ischemic stroke to lower the risk of stroke-related morbidity (rate of illness) and mortality (rate of death).

Antithrombotics at Discharge

• What are we measuring?
  • The percentage of ischemic stroke patients prescribed antithrombotics at discharge.
• Why is this important?
  • Studies have suggested that antithrombotics (medications that reduce the formation of blood clots) should be prescribed at discharge following ischemic stroke to lower the risk of future strokes and stroke-related morbidity (rate of illness) and mortality (rate of death).

Discharged on Cholesterol-Reducing Medication

• What are we measuring?
  • The percentage of ischemic stroke patients with an LDL ("bad" cholesterol) level greater than 100, an LDL not measured, or who were on cholesterol-lowering therapy before hospitalization, that are discharged from the hospital on statins (cholesterol-lowering drugs).
• Why is this important?
  • A high serum lipid level is a risk factor for coronary artery disease. Studies have shown that intensive lipid-lowering therapy using statin medication can dramatically lower the chances of future strokes and heart attacks.

Smoking Cessation

• What are we measuring?
  • The percentage of patients with ischemic or hemorrhagic stroke with a history of smoking cigarettes, or their caregivers, who are given smoking cessation advice or counseling during their hospital stay.
• Why is this important?
  • Smoking nearly doubles the risk of ischemic stroke. Studies have shown a large drop in the risk of stroke for former smokers, as well as the death rate from coronary heart disease.

NIHSS

• What are we measuring?
  • NIHSS done prior to acute recanalization or within 12 hours of hospital arrival for non-intervention patients.
• Why is this important?
  • This is a well-recognized standardized exam that allows us to measure a patient’s neurological deficits and monitor for any changes and improvement.