Rate and adequacy of cholesterol screening in patients admitted to a large rehabilitation unit after stroke

Objective To assess cholesterol screening and intervention among patients admitted with acute ischemic stroke to an inpatient rehabilitation unit. Design Descriptive retrospective study. Setting Rehabilitation unit of a large midwestern teaching hospital. Participants All patients over the age of 18 years admitted to a rehabilitation unit between January 1, 1999, and December 30, 2000, with acute ischemic stroke. One hundred fourteen patients (60 men, 54 women) with a median age of 74.4 years (range, 31.6-96.1y) met the inclusion criteria. Patients with a coexisting illness likely to lead to near-term death were excluded from analysis. Interventions Not applicable. Main outcome measures The proportion of patients with lipid profiles obtained at admission or within the year preceding admission, the proportion of patients with documented hyperlipidemia on lipid treatment, and the proportion of patients being treated who met National Cholesterol Education Program (NCEP) guidelines for low-density lipoprotein cholesterol control. Results Of the 114 subjects, 29 (25%) underwent cholesterol screening within the first 48 hours of hospitalization, and 27 (32%) had been screened within the preceding year. Of the 67 patients diagnosed with hyperlipidemia, 33 (49%) were taking cholesterol-lowering medical therapy when admitted, and 38 (57%) were under treatment when discharged from the rehabilitation unit. Three of the 5 patients diagnosed with hyperlipidemia before their hospitalization who were taking lipid-lowering medical therapy and were screened at admission met the NCEP prevention goals. Conclusions Cholesterol monitoring and treatment intervention in patients hospitalized in US rehabilitation units after acute stroke may be inadequate. More research and health care provider education is warranted.