Recommendations for the establishment of primary stroke centers

Mark J. Alberts, George Hademenos, Richard E. Latchaw, Andrew Jagoda, John R. Marler, Marc R. Mayberg, Rodman D. Starke, Harold W. Todd, Kenneth M. Viste, Meighan Girgus, Tim Shephard, Marian Emr, Patti Shwayder, Michael D. Walker

Research output: Contribution to journalArticle

550 Citations (Scopus)

Abstract

Objective: To develop recommendations for the establishment and operation of primary stroke centers as an approach to improve the medical care of patients with stroke. Participants: Members of the Brain Attack Coalition (BAC), a multidisciplinary group of representatives from major professional organizations involved with delivering stroke care. Supplemental input was obtained from other experts involved in acute stroke care. Evidence: A review of literature published from 1966 to March 2000 was performed using MEDLINE. More than 600 English-language articles that had evidence from randomized clinical trials, meta-analyses, care guidelines, or other appropriate methods supporting specific care recommendations for patients with acute stroke that could be incorporated into a stroke center model were selected. Consensus Process: Articles were reviewed initially by 1 author (M.J.A.). Members of the BAC reviewed each recommendation in the context of current practice parameters, with special attention to improving the delivery of care to patients with acute stroke, cost-effectiveness, and logistical issues related to the establishment of primary stroke centers. Consensus was reached among all BAC participants before an element was added to the list of recommendations. Conclusions: Randomized clinical trials and observational studies suggest that several elements of a stroke center would improve patient care and outcomes. Key elements of primary stroke centers include acute stroke teams, stroke units, written care protocols, and an integrated emergency response system. Important support services include availability and interpretation of computed tomography scans 24 hours everyday and rapid laboratory testing. Administrative support, strong leadership, and continuing education are also important elements for stroke centers. Adoption of these recommendations may increase the use of appropriate diagnostic and therapeutic modalities and reduce peristroke complications. The establishment of primary stroke centers has the potential to improve the care of patients with stroke.

Original languageEnglish (US)
Pages (from-to)3102-3109
Number of pages8
JournalJournal of the American Medical Association
Volume283
Issue number23
StatePublished - Jun 21 2000

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Stroke
Patient Care
Consensus
Brain
Randomized Controlled Trials
Continuing Education
MEDLINE
Cost-Benefit Analysis
Observational Studies
Meta-Analysis
Emergencies
Language
Tomography
Guidelines

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Alberts, M. J., Hademenos, G., Latchaw, R. E., Jagoda, A., Marler, J. R., Mayberg, M. R., ... Walker, M. D. (2000). Recommendations for the establishment of primary stroke centers. Journal of the American Medical Association, 283(23), 3102-3109.

Recommendations for the establishment of primary stroke centers. / Alberts, Mark J.; Hademenos, George; Latchaw, Richard E.; Jagoda, Andrew; Marler, John R.; Mayberg, Marc R.; Starke, Rodman D.; Todd, Harold W.; Viste, Kenneth M.; Girgus, Meighan; Shephard, Tim; Emr, Marian; Shwayder, Patti; Walker, Michael D.

In: Journal of the American Medical Association, Vol. 283, No. 23, 21.06.2000, p. 3102-3109.

Research output: Contribution to journalArticle

Alberts, MJ, Hademenos, G, Latchaw, RE, Jagoda, A, Marler, JR, Mayberg, MR, Starke, RD, Todd, HW, Viste, KM, Girgus, M, Shephard, T, Emr, M, Shwayder, P & Walker, MD 2000, 'Recommendations for the establishment of primary stroke centers', Journal of the American Medical Association, vol. 283, no. 23, pp. 3102-3109.
Alberts MJ, Hademenos G, Latchaw RE, Jagoda A, Marler JR, Mayberg MR et al. Recommendations for the establishment of primary stroke centers. Journal of the American Medical Association. 2000 Jun 21;283(23):3102-3109.
Alberts, Mark J. ; Hademenos, George ; Latchaw, Richard E. ; Jagoda, Andrew ; Marler, John R. ; Mayberg, Marc R. ; Starke, Rodman D. ; Todd, Harold W. ; Viste, Kenneth M. ; Girgus, Meighan ; Shephard, Tim ; Emr, Marian ; Shwayder, Patti ; Walker, Michael D. / Recommendations for the establishment of primary stroke centers. In: Journal of the American Medical Association. 2000 ; Vol. 283, No. 23. pp. 3102-3109.
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AU - Latchaw, Richard E.

AU - Jagoda, Andrew

AU - Marler, John R.

AU - Mayberg, Marc R.

AU - Starke, Rodman D.

AU - Todd, Harold W.

AU - Viste, Kenneth M.

AU - Girgus, Meighan

AU - Shephard, Tim

AU - Emr, Marian

AU - Shwayder, Patti

AU - Walker, Michael D.

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