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Limiting the Damage of Stroke

Seven factors at stroke centers increased use of powerful drug, study says

SATURDAY, Feb. 7, 2004 (HealthDayNews) -- Seven factors improve the likelihood that ischemic stroke patients will be given powerful clot-busting drugs.

That news came during a presentation Feb. 6 at the American Stroke Association's annual meeting in San Diego.

Clinical studies have shown tPA (tissue plasminogen activator) reduces the debilitating and crippling effects of stroke, but the drug has to be given within three hours of the start of stroke symptoms.

In 2000, a group of stroke experts called the Brain Attack Coalition (BAC) suggested stroke patient care and outcomes could be improved by defining and establishing primary stroke centers. The experts listed 11 major criteria for these primary stroke centers.

But, at the time, there was little evidence in medical literature to indicate which specific factors improved stroke care at such centers. That was the focus of this new study, which gathered information from 34 academic medical institutions.

"We wanted to see how well the Brain Attack Coalition recommendations actually predicted patient outcome and better quality of care in stroke centers," says the study's senior author, Dr. S. Claiborne Johnston, director of stroke services at the University of California, San Francisco Medical Center.

"We found that seven of 11 recommended criteria increased the use of tPA. The more of these seven criteria that a center followed, the greater the use of the drug," Johnston adds in a prepared statement.

Having written procedures for treating stroke was the most influential factor, followed by: integrating emergency medical personnel into the treatment effort; an emergency room staff well trained in recognizing stroke; and continuing medical education in stroke for all members of the stroke team.

The other three important criteria were: having a stroke team on call around the clock, seven days a week; having a formal stroke unit that provides specialized monitoring and care; and rapid availability of CT scans to assess whether the stroke was caused by a blood clot or a hemorrhaging blood vessel.

More information

Here's where you can learn more about the clot-buster drug tPA.

SOURCE: American Heart Association, news release, Feb. 6, 2004
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