Study examines out-of hospital stroke policy at Chicago hospitals

July 1, 2013, The JAMA Network Journals

Implementing an out-of hospital stroke policy in some Chicago hospitals was associated with significant improvements in emergency medical services use and increased intravenous tissue plasminogen activator (tPA) use at primary stroke centers, according to a study published by JAMA Neurology.

The study evaluated the relationship between a citywide policy recommending pre-hospital triage of patients with suspected stroke to transport them to the nearest primary stroke center and use of intravenous tPA use. The therapy is used to restore blood flow through blocked arteries in (IS).

The study by Shyam Prabhakaran, M.D., M.S., of Northwestern University, Chicago, and colleagues included all admitted patients with stroke and transient ischemic attack (also known as a "mini-stroke" or "warning stroke,") at 10 primary stroke center hospitals in Chicago. The study was conducted from September 2010 to August 2011, which was six months before and six months after the intervention began March 1, 2011.

There were 1,075 admissions for stroke and in the pre-triage periods and 1,172 admissions in the post-triage period. Compared with the pre-triage period, use of increased from 30.2 percent to 38.1 percent and emergency medical services pre-notification increased from 65.5 percent to 76.5 percent after implementation. Rates of intravenous tPA use were 3.8 percent and 10.1 percent and onset-to-treatment times decreased from 171.7 to 145.7 minutes in the pre-triage and post-triage periods, respectively, according to the study results.

"A citywide stroke system of care that includes a preferential triage policy and paramedic and public education can have a significant, immediate, sustainable impact on IV tPA use," the study concludes.

Explore further: Certified stroke centers more likely to give clot-busting drugs

More information: JAMA Neurol. Published online July 1, 2013. doi:10.1001/.jamaneurol.2013.293

Related Stories

Certified stroke centers more likely to give clot-busting drugs

March 26, 2013
Stroke patients are three times more likely to receive clot-busting medication if treated at a certified stroke center, according to a study in the Journal of the American Heart Association.

Earlier treatment following stroke linked with reduced risk of in-hospital death

June 18, 2013
In a study that included nearly 60,000 patients with acute ischemic stroke, thrombolytic treatment (to help dissolve a blood clot) that was started more rapidly after symptom onset was associated with reduced in-hospital ...

Timely treatment after stroke is crucial, researchers report

June 19, 2013
For years, the mantra of neurologists treating stroke victims has been "time equals brain." That's because getting a patient to the emergency room quickly to receive a drug that dissolves the stroke-causing blood clot can ...

Risk of death from ischemic stroke appears to have decreased in US black children

June 24, 2013
The excess risk of death from ischemic (due to reduced blood flow), but not hemorrhagic (due to bleeding), stroke in US black children has decreased over the past decade, according to a study by Laura L. Lehman, M.D., of ...

Lean process methods expedite care in ischemic stroke

November 10, 2012
(HealthDay)—Use of lean process improvement methodology can reduce the time to stroke care without compromising patient safety, according to a study published online Nov. 8 in Stroke.

People having stroke should get therapy within 60 minutes of hospital arrival

January 31, 2013
People having an ischemic stroke should receive clot-dissolving therapy – if appropriate—within 60 minutes of arriving at the hospital, according to new American Stroke Association guidelines published in the American ...

Recommended for you

Midbrain 'start neurons' control whether we walk or run

January 17, 2018
Locomotion comprises the most fundamental movements we perform. It is a complex sequence from initiating the first step, to stopping when we reach our goal. At the same time, locomotion is executed at different speeds to ...

Recording a thought's fleeting trip through the brain

January 17, 2018
University of California, Berkeley neuroscientists have tracked the progress of a thought through the brain, showing clearly how the prefrontal cortex at the front of the brain coordinates activity to help us act in response ...

Brain zaps may help curb tics of Tourette syndrome

January 16, 2018
Electric zaps can help rewire the brains of Tourette syndrome patients, effectively reducing their uncontrollable vocal and motor tics, a new study shows.

A 'touching sight': How babies' brains process touch builds foundations for learning

January 16, 2018
Touch is the first of the five senses to develop, yet scientists know far less about the baby's brain response to touch than to, say, the sight of mom's face, or the sound of her voice.

Researchers identify protein involved in cocaine addiction

January 16, 2018
Mount Sinai researchers have identified a protein produced by the immune system—granulocyte-colony stimulating factor (G-CSF)—that could be responsible for the development of cocaine addiction.

Neuroscientists suggest a model for how we gain volitional control of what we hold in our minds

January 16, 2018
Working memory is a sort of "mental sketchpad" that allows you to accomplish everyday tasks such as calling in your hungry family's takeout order and finding the bathroom you were just told "will be the third door on the ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.