Stroke Designated Centers Prove They Save More Lives
If you experience a stroke, admission to a stroke designated center could make the difference between life and death. According to a study released ahead of publication by JAMA, patients who experienced an ischemic stroke and were admitted to a stroke designated center had a lower risk of death than those admitted to hospitals without the designation.
The study conducted by Duke Clinical Research Institute looked the data from approximately 31,000 patients who were admitted to a hospital facility following an acute ischemic stroke between 2005 and 2006. They found that the overall 30 day mortality rate for patients admitted to a stroke designated center was 10.1 percent and for those admitted to a non-designated facility 12.5 percent. This was a 2.5 percent reduction in overall risk for death.
Although the results are modest, it provides evidence that 2003 implementation of stroke designated centers has saved lives. The implementation of these centers came in the wake of the Brain Attack Coalition (BAC) recommendations in 2000 to improve stroke care in the hospital setting. In the eleven years since the recommendations were released nearly 15 percent of all acute care facilities have become Joint Commission Certified (JCAHO) stroke centers.
The process of certifying a JCAHO stroke center requires the implementation of eleven items, including a written protocol for plan of care for suspected strokes and the consideration for administration of anti-thrombotic medications (medications which dissolve blood clots). The researchers at Duke Clinical Research Institute found that anti-thrombotic therapy was used in 4.8 percent of cases at stroke designated centers and only 1.7 percent at non-designated facilities. This is one of several factors which could explain the death reduction at stroke centers.
Stroke is the third leading cause of death in the United States and continued efforts are needed to reduce overall mortality. The implementation of stroke designated centers is a solid start in this reduction. Dr. Mark Alberts of the Stroke Program at Northwestern University School of Medicine in Chicago comments on the future of acute stroke care centers,
“A multitiered system of stroke care is developing, with the comprehensive stroke center (CSC) at the top of the pyramid, the primary stroke center (PSC) in the middle, and the acute stroke ready hospital (ASRH) at the base.”
This type of tired system would hopefully continue to improve the care of stroke victims and reduce the overall risk for death and long term disability.