Stroke Centers May Offer Best Shot at Recovery
Specialty facilities are more apt to give needed treatment, and faster, study finds
THURSDAY, Oct. 29, 2009 (HealthDay News) -- Stroke patients taken directly to a designated stroke center are much more likely to receive the clot-busting drug tPA than those taken to the nearest hospital, says a new study.
If given within the first few hours after a stroke, tPA (tissue plasminogen activator) can reduce stroke-related disability.
The study grew out of a citywide program in Toronto that trains paramedics to screen for stroke and to take stroke patients to one of three regional stroke centers. The researchers examined the impact of the protocol at one of the stroke centers -- Sunnybrook Health Sciences Centre -- in the first four months of the program and compared it with the same four-month period the previous year.
After implementation of the program, the percentage of stroke patients arriving at Sunnybrook less than two and a half hours after a stroke increased from 30 percent to 49 percent, with a four-fold increase in the number of people treated with tPA.
The study also found that the protocol led to significantly faster tPA treatment times and that the average hospital stay for stroke patients was reduced from five days to four.
The findings were published online Oct. 29 and will be in the December issue of Stroke.
"Protocols like this are necessary because not all hospitals offer thrombolytic therapy, and too many patients arrive at a hospital too late to receive treatment," lead author Dr. David Gladstone, an assistant professor of medicine at the University of Toronto and director of the Regional Stroke Prevention Clinic at Sunnybrook, said in a news release from the American Heart Association.
"Effective delivery of tPA for stroke requires an emergency response and a coordinated team approach involving paramedics, hospital stroke teams, emergency room and radiology personnel, and inpatient medical and intensive care staff," Gladstone said. "Time is brain. The faster the treatment is given, the greater the chance of a good outcome. Every minute counts during an acute stroke."
The American Heart Association has more about tPA.