Patients who suffer strokes and are seen at designated stroke centers fare better in the short and long run
Since 2003, the Joint Commission has certified almost 700 hospitals in the United States as stroke centers. These hospitals adhere to the Brain Attack Coalition's guidelines to improve care and outcomes when a patient suffers a stroke. A new study finds that patients who suffer ischemic stroke and are admitted to stroke centers have slightly lower mortality rates and are more frequently given clot-busting (thrombolytic) therapy, which can help limit the damage and disability a stroke can cause.
Researchers compared data from nearly 31,000 patients who suffered ischemic strokes and were treated either at New York's 104 designated stroke centers or other nondesignated hospitals in the State. The 30-day mortality rate for the 15,297 patients seen at stroke centers was 10.1 percent compared with 12.5 percent for the 15,650 patients seen at other hospitals. In addition to better short-term survival rates, patients seen at stroke centers had better long-term survival rates (up to 1 year) than patients seen at other hospitals. Further, 4.8 percent of patients seen at stroke centers received thrombolytic therapy compared with 1.7 percent of patients treated at nondesignated hospitals.
The authors did not find similar lower mortality rates at stroke centers for patients suffering from other life-threatening conditions, including gastrointestinal hemorrhage and heart attacks. This finding indicates that the better mortality rates for patients who suffered strokes were a result of adherence to stroke treatment guidelines and not other quality improvement initiatives undertaken at the hospital. Although the differences in mortality rates were modest, they do demonstrate that patients seen at designated stroke centers enjoy better outcomes than patients seen at other hospitals, the authors suggest. This study was funded in part by the Agency for Healthcare Research and Quality (HS169649).
See "Association between stroke center hospitalization for acute ischemic stroke and mortality," by Ying Xian, M.D., Ph.D., Robert G. Holloway, M.D., M.P.H., Paul S. Chan, M.D., M.S., and others in the January 26, 2011 Journal of the American Medical Association 305(4), pp. 373-380.
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