Impact of Establishing a Primary Stroke Center at a Community Hospital on the Use of Thrombolytic TherapyThe NINDS Suburban Hospital Stroke Center Experience
作者:
Susan Lattimore,
Julio Chalela,
Lisa Davis,
Thomas DeGraba,
Mustapha Ezzeddine,
Joseph Haymore,
Paul Nyquist,
Alison Baird,
John Hallenbeck,
Steven Warach,
期刊:
Stroke: Journal of the American Heart Association
(OVID Available online 2003)
卷期:
Volume 34,
issue 6
页码: 55-57
ISSN:0039-2499
年代: 2003
出版商: OVID
关键词: emergency medical services;hospital planning;stroke units;stroke, acute;thrombolytic therapy
数据来源: OVID
摘要:
Background and Purpose—To increase the proportion of ischemic stroke patients treated with thrombolytic therapy, the establishment of primary stroke centers in community hospitals has been advocated. We evaluated the use of thrombolytic therapy before and after institution of a primary stroke center in a community hospital.Methods—The availability of an on-call stroke emergency response team was the only significant additional resource required for this hospital. All eligible patients were treated with intravenous tissue plasminogen activator (tPA). The number of patients with cerebrovascular disease, number and proportion of patients treated with tPA, times to treatment, and patient outcomes were recorded during the first 2 years of the stroke center.Results—During the 12 months before institution of the stroke center, 3 ischemic stroke patients (1.5%) were treated with tPA. During the 2-year period of around-the-clock coverage, 44 of 420 ischemic stroke patients (10.5%) were treated with intravenous tPA, a significant increase in tPA use (P<0.0001).Conclusions—Establishment of a primary stroke center at a community hospital resulted in a substantial increase in the proportion of patients receiving thrombolytic therapy for ischemic stroke. If this experience is generalized, the beneficial impact of primary stroke centers on stroke outcomes and costs to the healthcare system may be substantial.
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