Neurology Outcomes 2012

n e u r o l o g y o u t c o m e s2 0 1 2

ta bl e of c on t e n t s

4 // Total Inpatient and Outpatient Visits, UCH Neurosciences

4 // Spinal Surgery Volumes

4 // Neurosurgery Volumes*

5-10 // Stroke Outcomes

5 // IV rt-PA Arrive by 2 Hour, Treat

by 3 Hour

5 // Early Antithrombotics

6 // VTE Prophylaxis

6 // Antithrombotics

7 // Anticoag for AFib/Aflutter

7 // LDL 100 or ND – Statin

8 // Stroke Education

8 // Rehabilitation Considered

9 // Cerebrovascular/Ischemic

Stroke – Mortality Index

9 // Cerebrovascular/Intracerebral

Hemorrhage – Mortality Index

10 // Cerebrovascular/Other

Volume

10 // Other Neurology &

Neurosurgery Volume

11 // Brain & CNS (Excluding

Benign Brain) 5 –Year Survival

11 // Brain (Including Benign Brain)

5 –Year Survival

12 // Brain (GBM Only) 5 –Year

Survival

12 // Epilepsy Volume

13 // Movement Disorder Volume

13 // Neuromuscular Volume

14 // MS Volume

14 // Neuro-Oncology Volume

15 // UCH Insider Article

3

The University of Colorado Hospital Difference…

The University of Colorado Hospital Department of Neurosciences is one of the nation’s leading neurosciences

programs and is comprised of some of the country’s top neurologists, neurosurgeons, neurointerventional

radiologists, neurocritical care specialists, neurohospitalists, NPs, PAs, researchers, social workers, counselors,

dieticians and other caregivers. With a multidisciplinary team that subspecializes in and treats a broad spectrum

of neurological conditions, the neurosciences division is a contributing reason why the University of Colorado

Hospital was recently named the top performing academic hospital in the nation by the University HealthSystem

Consortium, again. For more information, please visit us at uch.edu.

university of colorado Hospital is tHe leading academic medical center in tHe nation.

University of Colorado Hospital (UCH) is recognized as the highest-performing academic hospital in the United

States for delivering quality health care by the University HealthSystem Consortium for two years in a row, and is

ranked as the best hospital in the Denver metro area and one of the best in the country by U.S. News & World Report.

UCH is best known as an innovator in patient care and often is one of the first hospitals to bring new medicine to the

patient’s bedside. The hospital’s physicians are affiliated with the University of Colorado School of Medicine, part of

the University of Colorado system. Based at the expansive Anschutz Medical Campus in Aurora, Colo., UCH is where

patient care, research and education converge to establish the future of health care delivery.

4

OU T C OME S d aTa

UCH  Confidential 1/2/13 Page  6  of  10

1325 1522 1664 1725 1857

7641 8629 9465 9717 10473

19806 22303

25681

29317 31217

2008 2009 2010 2011 2012

Neurosciences Service Line FY 2008 - FY 2012 Trend Over Time

Outpatient Visits, Inpt Admissions & Days

Inpatient Admissions Inpatient Days Outpatient Visits

256 270 294 350 359

1306 1500

1293 1422 1360

2922 3063 3344

3709

4218

2008 2009 2010 2011 2012

Epilepsy FY 2008 - FY 2012 Trend Over Time

Outpatient Visits, Inpt Admissions & Days Inpatient Admissions Inpatient Days Outpatient Visits

t o t a l i n p a t i e n t a n d o u t p a t i e n t v i s i t s , u c H n e u r o s c i e n c e s

s p i n a l s u r g e r y v o l u m e s n e u r o s u r g e r y v o l u m e s **excludes spinal surgeries.

spinal  surgery 2008 2009 2010 2011 2012Volumes 469 563 537 613 883

neurosurgery  volumes2008 2009 2010 2011 2012190 474 951 1010 1002

469

563 537

613

883

2008 2009 2010 2011 2012

Title Series1

190

474

951 1010 1002

2008 2009 2010 2011 2012

Title Series1

Based on the July 1 - June 30 fiscal year

Inpatient Admissions Inpatient Days Outpatient VisitsK e y

5

69.2

% 85

.7%

92.9

%

91.3

%

100.

0%

100.

0%

66.2

%

71.4

%

79.4

%

82.2

%

84.3

%

82.7

%

62.8

% 75

.9%

79.7

%

83.6

%

83.4

%

81.1%

60.8

0%

64.3

%

74.2

0%

77.0

0%

79.0

0%

79.10

%

2007 2008 2009 2010 2011 2012

Perc

ent o

f Pat

ient

s

IV rt-PA Arrive by 2 Hour, Treat by 3 Hour UCH Academic Hospitals Colorado National

93.3

%

100.

0%

98.7

% 10

0.0%

98.6

% 10

0.0%

96.6

%

96.5

%

96.9

%

97.2

%

97.4

%

97.2

%

95.1%

96.1%

96.7

%

96.1%

97.4

%

97.2

%

96.10

%

96.2

%

96.4

0%

96.6

0%

97.10

%

97.2

0%

2007 2008 2009 2010 2011 2012

Perc

ent o

f Pat

ient

s

Early Antithrombotics UCH Academic Hospitals Colorado National

UCH Academic Hospitals Colorado NationalK e y

UCH Academic Hospitals Colorado NationalK e y

i v r t - p a a r r i v e b y 2 H o u r , t r e a t b y 3 H o u r

e a r l y a n t i t H r o m b o t i c s

Based on the calendar year

6

OU T C OME S d aTa96

.9%

99.2

%

100.

0%

100.

0%

100.

0%

100.

0%

95.4

%

97.3

%

97.8

%

98.1%

98.3

%

97.8

%

94.3

%

96.9

%

97.4

%

97.8

%

98.2

%

98.9

%

94.8

0%

96.9

%

97.6

0%

97.4

0%

97.9

0%

97.8

0%

2007 2008 2009 2010 2011 2012

Perc

ent o

f Pat

ient

s

Antithrombotics UCH Academic Hospitals Colorado National

97.1%

100.

0%

100.

0%

99.2

%

98.6

%

99.4

%

90.9

% 94

.0%

94.6

%

94.3

%

95.4

%

94.9

%

91.4

%

95.6

%

95.7

%

92.7

%

94.1%

87.9

%

88.2

0% 92

.0%

92.6

0%

91.8

0%

93.2

0%

93.9

0%

2007 2008 2009 2010 2011 2012

Perc

ent o

f Pat

ient

s

DV/VTE Prophylaxis UCH Academic Hospitals Colorado National

d v t / v t e p r o p H y l a x i s

a n t i t H r o m b o t i c s a t d i s c H a r g e

UCH Academic Hospitals Colorado NationalK e y

UCH Academic Hospitals Colorado NationalK e y

Based on the calendar year

7

69.7

% 82

.8%

100.

0%

95.7

%

97.4

%

100.

0%

70.6

%

76.3

% 89

.3%

91.2

%

91.9

%

93.2

%

60.7

%

64.0

%

86.9

%

86.4

%

86.8

%

89.8

%

67.3

0%

73.4

% 87

.70%

88.6

0%

89.70

%

91.6

0%

2007 2008 2009 2010 2011 2012

Perc

ent o

f Pat

ient

s

LDL 100 or ND Statin UCH Academic Hospitals Colorado National

100.

0%

100.

0%

100.

0%

100.

0%

100.

0%

100.

0%

90.9

%

95.1%

95.4

%

95.7

%

95.5

%

95.0

%

94.8

%

94.7

%

94.2

%

92.9

%

90.4

%

96.0

%

89.3

0% 93

.0%

93.4

0%

93.4

0%

93.3

0%

93.3

0%

2007 2008 2009 2010 2011 2012

Perc

ent o

f Pat

ient

s

Anticoag for Afib/Aflutter UCH Academic Hospitals Colorado National

a n t i c o a g f o r a f i b / a f l u t t e r

l d l 1 0 0 o r n d – s t a t i n

UCH Academic Hospitals Colorado NationalK e y

UCH Academic Hospitals Colorado NationalK e y

Based on the calendar year

8

OU T C OME S d aTa0.

0%

67.8

%

68.2

%

69.2

%

99.2

%

93.5

%

8.4%

66.3

% 76

.5%

83.4

%

87.4

%

89.2

%

14.9

%

43.0

%

64.1%

70.7

%

76.5

% 87

.5%

8.30

%

64.4

% 75

.20%

80.70

%

85.4

0%

88.8

0%

2007 2008 2009 2010 2011 2012

Perc

ent o

f Pat

ient

s

Stroke Education UCH Academic Hospitals Colorado National

91.1%

89.3

%

98.7

%

99.4

%

99.3

%

100.

0%

74.6

%

94.9

%

97.0

%

97.5

%

97.6

%

97.5

%

73.7

% 88

.9%

95.3

%

95.8

%

95.8

%

96.7

%

73.6

0%

94.2

%

96.4

0%

96.6

0%

96.8

0%

97.10

%

2007 2008 2009 2010 2011 2012

Perc

ent o

f Pat

ient

s

Rehabilitation Considered UCH Academic Hospitals Colorado National

s t r o K e e d u c a t i o n

r e H a b i l i t a t i o n c o n s i d e r e d

UCH Academic Hospitals Colorado NationalK e y

UCH Academic Hospitals Colorado NationalK e y

Based on the calendar year

9

0.77

0.85

Mortality Index 2012

Title UCH

0.8

0.93

Mortality Index 2012

Title UCH

0.77

0.85

Mortality Index 2012

Title UCH

0.8

0.93

Mortality Index 2012

Title UCH

i s c H e m i c s t r o K e – m o r t a l i t y i n d e xLower is better (compared to national averages from UHC Reporting Hospitals)

H e m o r r H a g i c s t r o K e – m o r t a l i t y i n d e xLower is better (compared to national averages from UHC Reporting Hospitals)

UCH

UHC Reporting HospitalsK e y

UCH

UHC Reporting HospitalsK e y

.08 loWer tHan uHc reporting Hospital s

.13 loWer tHan uHc reporting Hospital s

Based on the July 1 - June 30 fiscal year

10

OU T C OME S d aTa

UCH  Confidential 1/2/13 Page  10  of  10

65 75 79 87 109

357 309

352 387

471

560

740 777

702

532

2008 2009 2010 2011 2012

Cerebrovascular / Other FY 2008 - FY 2012 Trend Over Time

Outpatient Visits, Inpt Admissions & Days

Inpatient Admissions Inpatient Days Outpatient Visits

365 404 453 476 512

1686 2215 2432 2594 2746

5764 6016 6436

7137

8512

2008 2009 2010 2011 2012

Neurology & Neurosurgery / Other FY 2008 - FY 2012 Trend Over Time

Outpatient Visits, Inpt Admissions & Days

Inpatient Admissions Inpatient Days Outpatient Visits

UCH  Confidential 1/2/13 Page  10  of  10

65 75 79 87 109

357 309

352 387

471

560

740 777

702

532

2008 2009 2010 2011 2012

Cerebrovascular / Other FY 2008 - FY 2012 Trend Over Time

Outpatient Visits, Inpt Admissions & Days

Inpatient Admissions Inpatient Days Outpatient Visits

365 404 453 476 512

1686 2215 2432 2594 2746

5764 6016 6436

7137

8512

2008 2009 2010 2011 2012

Neurology & Neurosurgery / Other FY 2008 - FY 2012 Trend Over Time

Outpatient Visits, Inpt Admissions & Days

Inpatient Admissions Inpatient Days Outpatient Visits

c e r e b r o v a s c u l a r / o t H e r v o l u m e

o t H e r n e u r o l o g y & n e u r o s u r g e r y v o l u m e

Inpatient Admissions Inpatient Days Outpatient VisitsK e y

Inpatient Admissions Inpatient Days Outpatient VisitsK e y

Based on the July 1 - June 30 fiscal year

11

72%

60% 51% 48% 47%

58%

44% 38% 36% 35%

Year 1 Year 2 Year 3 Year 4 Year 5

Brain & CNS (excluding Benign Brain) 5 Year Survival

UCH State

72%

59% 52% 49% 47%

60%

48% 42% 40% 39%

50%

33% 27% 24% 22%

Year 1 Year 2 Year 3 Year 4 Year 5

Brain (including Benign Brain) 5 Year Survival

UCH State National

72%

60% 51% 48% 47%

58%

44% 38% 36% 35%

Year 1 Year 2 Year 3 Year 4 Year 5

Brain & CNS (excluding Benign Brain) 5 Year Survival

UCH State

72%

59% 52% 49% 47%

60%

48% 42% 40% 39%

50%

33% 27% 24% 22%

Year 1 Year 2 Year 3 Year 4 Year 5

Brain (including Benign Brain) 5 Year Survival

UCH State National

UCH ColoradoK e y

UCH ColoradoK e y

Observed survival data based on patients diagnosed between 2003 – 2005.

Observed survival data based on patients diagnosed between 2003 – 2005.

b r a i n & c n s ( e x c l u d i n g b e n i g n b r a i n ) 5 – y e a r s u r v i v a l

b r a i n ( i n c l u d i n g b e n i g n b r a i n ) 5 –y e a r s u r v i v a l

Based on the calendar year

12

OU T C OME S d aTa

UCH  Confidential 1/2/13 Page  6  of  10

1325 1522 1664 1725 1857

7641 8629 9465 9717 10473

19806 22303

25681

29317 31217

2008 2009 2010 2011 2012

Neurosciences Service Line FY 2008 - FY 2012 Trend Over Time

Outpatient Visits, Inpt Admissions & Days

Inpatient Admissions Inpatient Days Outpatient Visits

256 270 294 350 359

1306 1500

1293 1422 1360

2922 3063 3344

3709

4218

2008 2009 2010 2011 2012

Epilepsy FY 2008 - FY 2012 Trend Over Time

Outpatient Visits, Inpt Admissions & Days Inpatient Admissions Inpatient Days Outpatient Visits

49%

26%

12% 11% 11%

36%

14% 7% 5% 4%

Year 1 Year 2 Year 3 Year 4 Year 5

Brain - GBM Only 5 Year Survival

UCH State

b r a i n ( g b m o n l y ) 5 – y e a r s u r v i v a l

e p i l e p s y v o l u m e

Inpatient Admissions Inpatient Days Outpatient VisitsK e y

UCH ColoradoK e y

Based on the calendar year

Observed survival data based on patients diagnosed between 2003 – 2005.

13

UCH  Confidential 1/2/13 Page  7  of  10

41 77 70 75 76 90 107 92 173 147

2095

2543 2353

2785 2824

2008 2009 2010 2011 2012

Movement Disorders FY 2008 - FY 2012 Trend Over Time

Outpatient Visits, Inpt Admissions & Days

Inpatient Admissions Inpatient Days Outpatient Visits

52 69 58 46 50 202 295 175 181 167

3382 3072 3206

3524

3054

2008 2009 2010 2011 2012

Neuromuscular FY 2008 - FY 2012 Trend Over Time

Outpatient Visits, Inpt Admissions & Days

Inpatient Admissions Inpatient Days Outpatient Visits

UCH  Confidential 1/2/13 Page  7  of  10

41 77 70 75 76 90 107 92 173 147

2095

2543 2353

2785 2824

2008 2009 2010 2011 2012

Movement Disorders FY 2008 - FY 2012 Trend Over Time

Outpatient Visits, Inpt Admissions & Days

Inpatient Admissions Inpatient Days Outpatient Visits

52 69 58 46 50 202 295 175 181 167

3382 3072 3206

3524

3054

2008 2009 2010 2011 2012

Neuromuscular FY 2008 - FY 2012 Trend Over Time

Outpatient Visits, Inpt Admissions & Days

Inpatient Admissions Inpatient Days Outpatient Visits

m o v e m e n t d i s o r d e r v o l u m e

n e u r o m u s c u l a r v o l u m e

Inpatient Admissions Inpatient Days Outpatient VisitsK e y

Inpatient Admissions Inpatient Days Outpatient VisitsK e y

Based on the July 1 - June 30 fiscal year

14

OU T C OME S d aTa

UCH  Confidential 1/2/13 Page  8  of  10

28 48 52 30 52 183 279 293 128 274

2548

3846

6318

7847 8575

2008 2009 2010 2011 2012

MS/Neuroimmunology FY 2008 - FY 2012 Trend Over Time

Outpatient Visits, Inpt Admissions & Days

Inpatient Admissions Inpatient Days Outpatient Visits

259 337 374 368 344

1275 1491

1749 1928

1782

2310

2704 2928

3325 3086

2008 2009 2010 2011 2012

Neuro-Oncology FY 2008 - FY 2012 Trend Over Time

Outpatient Visits, Inpt Admissions & Days

Inpatient Admissions Inpatient Days Outpatient Visits

UCH  Confidential 1/2/13 Page  8  of  10

28 48 52 30 52 183 279 293 128 274

2548

3846

6318

7847 8575

2008 2009 2010 2011 2012

MS/Neuroimmunology FY 2008 - FY 2012 Trend Over Time

Outpatient Visits, Inpt Admissions & Days

Inpatient Admissions Inpatient Days Outpatient Visits

259 337 374 368 344

1275 1491

1749 1928

1782

2310

2704 2928

3325 3086

2008 2009 2010 2011 2012

Neuro-Oncology FY 2008 - FY 2012 Trend Over Time

Outpatient Visits, Inpt Admissions & Days

Inpatient Admissions Inpatient Days Outpatient Visits

n e u r o - o n c o l o g y v o l u m e

m s v o l u m e

Inpatient Admissions Inpatient Days Outpatient VisitsK e y

Inpatient Admissions Inpatient Days Outpatient VisitsK e y

Based on the July 1 - June 30 fiscal year

15

u c H i n s i d e r a r t i c l e

Volume 6 | Issue 2 | Through July 31, 2012

Subscribe: The Insider is delivered free via email every other Wednesday. To subscribe: [email protected]: We want your input, feedback, notices of stories we’ve missed. To comment: [email protected]

Continued

Record-setting treatment

Stroke Victim Returns to Neuro ICU to Thank UCH Providers

Among those on hand to speak to Hamilton was interventional radiologist David Kumpe, MD, who threaded a catheter through Hamilton’s femoral artery to the clot in the right middle cerebral artery that caused the stroke. Kumpe delivered a second dose of

To say Rick Hamilton’s visit last week to the Neuro Intensive Care Unit at University of Colorado Hospital was different than the one he made last fall would be quite an understatement.

The last time the Illinois man had seen the unit and many of the providers who gathered there to greet him July 12, he was only hours removed from a brush with serious disability – if not death – caused by a stroke he suffered while on a Halloween Day flight from St. Louis to Salt Lake City.

After an emergency landing at Denver International Airport, paramedics rushed Hamilton to UCH, where a team of providers admitted him to the Emergency Department, assessed him, obtained and interpreted a CT image and administered clot-busting medication in a record 18 minutes.

After some additional tense moments and a four-day Neuro ICU stay, Hamilton walked out of the hospital with no residual effects from the stroke (Insider, Nov. 30, 2011).

“It’s rewarding to walk back through this journey and see the people who played this role,” Hamilton told the small crowd in the Neuro ICU.

Rick Hamilton (center, left), who suffered a stroke aboard an airplane last Halloween, applauds UCH providers during a visit to the Neuro ICU last week.

Hamilton speaks with neurohospitalist Matt West, MD, center, who was a member of the team that treated him. Hospitalist Ethan Cumbler, MD, stands far right.

Hamilton and West with ( from left) interventional radiologist David Kumpe and Neuro ICU Medical Director Robert Neumann, MD.

Volume 6 | Issue 2 | Through July 31, 2012 | Page 2

tissue plasminogen activator (tPA), this one directly to the clot, which dissolved.

Kumpe spoke of the good that came out of Hamilton’s ordeal. Referring to the hospital’s record-setting response to the case, Kumpe said, “Little has been said about the effect that you had on us. You set a benchmark for us.”

An avid golfer, Hamilton said he’s not quite back to playing 18 holes, but only because of a sore shoulder.

He was happy to come back under his own power to say thanks to those he met under far different circumstances.

“Thank you to the people who allowed me to do this,” Hamilton said.

For more on Hamilton’s visit to UCH, watch the story aired on 9News.

Volume 6 | Issue 2 | Through July 31, 2012

Subscribe: The Insider is delivered free via email every other Wednesday. To subscribe: [email protected]: We want your input, feedback, notices of stories we’ve missed. To comment: [email protected]

Continued

Record-setting treatment

Stroke Victim Returns to Neuro ICU to Thank UCH Providers

Among those on hand to speak to Hamilton was interventional radiologist David Kumpe, MD, who threaded a catheter through Hamilton’s femoral artery to the clot in the right middle cerebral artery that caused the stroke. Kumpe delivered a second dose of

To say Rick Hamilton’s visit last week to the Neuro Intensive Care Unit at University of Colorado Hospital was different than the one he made last fall would be quite an understatement.

The last time the Illinois man had seen the unit and many of the providers who gathered there to greet him July 12, he was only hours removed from a brush with serious disability – if not death – caused by a stroke he suffered while on a Halloween Day flight from St. Louis to Salt Lake City.

After an emergency landing at Denver International Airport, paramedics rushed Hamilton to UCH, where a team of providers admitted him to the Emergency Department, assessed him, obtained and interpreted a CT image and administered clot-busting medication in a record 18 minutes.

After some additional tense moments and a four-day Neuro ICU stay, Hamilton walked out of the hospital with no residual effects from the stroke (Insider, Nov. 30, 2011).

“It’s rewarding to walk back through this journey and see the people who played this role,” Hamilton told the small crowd in the Neuro ICU.

Rick Hamilton (center, left), who suffered a stroke aboard an airplane last Halloween, applauds UCH providers during a visit to the Neuro ICU last week.

Hamilton speaks with neurohospitalist Matt West, MD, center, who was a member of the team that treated him. Hospitalist Ethan Cumbler, MD, stands far right.

Hamilton and West with ( from left) interventional radiologist David Kumpe and Neuro ICU Medical Director Robert Neumann, MD.

Volume 6 | Issue 2 | Through July 31, 2012

Subscribe: The Insider is delivered free via email every other Wednesday. To subscribe: [email protected]: We want your input, feedback, notices of stories we’ve missed. To comment: [email protected]

Continued

Record-setting treatment

Stroke Victim Returns to Neuro ICU to Thank UCH Providers

Among those on hand to speak to Hamilton was interventional radiologist David Kumpe, MD, who threaded a catheter through Hamilton’s femoral artery to the clot in the right middle cerebral artery that caused the stroke. Kumpe delivered a second dose of

To say Rick Hamilton’s visit last week to the Neuro Intensive Care Unit at University of Colorado Hospital was different than the one he made last fall would be quite an understatement.

The last time the Illinois man had seen the unit and many of the providers who gathered there to greet him July 12, he was only hours removed from a brush with serious disability – if not death – caused by a stroke he suffered while on a Halloween Day flight from St. Louis to Salt Lake City.

After an emergency landing at Denver International Airport, paramedics rushed Hamilton to UCH, where a team of providers admitted him to the Emergency Department, assessed him, obtained and interpreted a CT image and administered clot-busting medication in a record 18 minutes.

After some additional tense moments and a four-day Neuro ICU stay, Hamilton walked out of the hospital with no residual effects from the stroke (Insider, Nov. 30, 2011).

“It’s rewarding to walk back through this journey and see the people who played this role,” Hamilton told the small crowd in the Neuro ICU.

Rick Hamilton (center, left), who suffered a stroke aboard an airplane last Halloween, applauds UCH providers during a visit to the Neuro ICU last week.

Hamilton speaks with neurohospitalist Matt West, MD, center, who was a member of the team that treated him. Hospitalist Ethan Cumbler, MD, stands far right.

Hamilton and West with ( from left) interventional radiologist David Kumpe and Neuro ICU Medical Director Robert Neumann, MD.