Impact of establishing a primary stroke center at a community hospital on the use of thrombolytic therapy: the NINDS Suburban Hospital Stroke Center experience.

Susan Unipan Lattimore, Julio Chalela, Lisa Davis, Thomas DeGraba, Mustapha Ezzeddine, Joseph Haymore, Paul Nyquist, Alison E. Baird, John Hallenbeck, Steven Warach

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Abstract

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.

Original languageEnglish (US)
JournalStroke; a journal of cerebral circulation
Volume34
Issue number6
StatePublished - 2003

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National Institute of Neurological Disorders and Stroke
Thrombolytic Therapy
Community Hospital
Stroke
Tissue Plasminogen Activator
Cerebrovascular Disorders

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Impact of establishing a primary stroke center at a community hospital on the use of thrombolytic therapy : the NINDS Suburban Hospital Stroke Center experience. / Lattimore, Susan Unipan; Chalela, Julio; Davis, Lisa; DeGraba, Thomas; Ezzeddine, Mustapha; Haymore, Joseph; Nyquist, Paul; Baird, Alison E.; Hallenbeck, John; Warach, Steven.

In: Stroke; a journal of cerebral circulation, Vol. 34, No. 6, 2003.

Research output: Contribution to journalArticle

Lattimore, SU, Chalela, J, Davis, L, DeGraba, T, Ezzeddine, M, Haymore, J, Nyquist, P, Baird, AE, Hallenbeck, J & Warach, S 2003, 'Impact of establishing a primary stroke center at a community hospital on the use of thrombolytic therapy: the NINDS Suburban Hospital Stroke Center experience.', Stroke; a journal of cerebral circulation, vol. 34, no. 6.
Lattimore, Susan Unipan ; Chalela, Julio ; Davis, Lisa ; DeGraba, Thomas ; Ezzeddine, Mustapha ; Haymore, Joseph ; Nyquist, Paul ; Baird, Alison E. ; Hallenbeck, John ; Warach, Steven. / Impact of establishing a primary stroke center at a community hospital on the use of thrombolytic therapy : the NINDS Suburban Hospital Stroke Center experience. In: Stroke; a journal of cerebral circulation. 2003 ; Vol. 34, No. 6.
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abstract = "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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AU - Lattimore, Susan Unipan

AU - Chalela, Julio

AU - Davis, Lisa

AU - DeGraba, Thomas

AU - Ezzeddine, Mustapha

AU - Haymore, Joseph

AU - Nyquist, Paul

AU - Baird, Alison E.

AU - Hallenbeck, John

AU - Warach, Steven

PY - 2003

Y1 - 2003

N2 - 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.

AB - 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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