January 26, 2011

Can Stroke Centers Help Reduce Death?

(Ivanhoe Newswire) -- A new study found that people who have suffered a stroke may be less likely to die if they are admitted to a hospital stroke center.

According to strokecenter.org, about 795,000 people suffer a stroke each year. Ischemic strokes occur when a blood vessel that supplies blood to the brain is blocked by a blood clot. With the hopes of improving acute stroke care, the Brain Attack Coalition (BAC) published recommendations for the establishment of primary stroke centers in 2000, and three years later, officials began certifying stroke centers based on those recommendations.

Ying Xian, M.D., Ph.D., of the Duke Clinical Research Institute, and his colleagues, found that people who had an ischemic stroke and were admitted to hospitals with stroke centers had a lower risk of death at 30 days compared to patients who were admitted to non-designated hospitals.

In the study, 49.4 percent of acute ischemic stroke patients were admitted to designated stroke centers, and 50.6 percent were admitted to non-designated hospitals. The patients were followed up for mortality for one year after hospitalization. The research indicated that admission to a designated stroke center hospital was associated with a 2.5 percent reduction in 30-day, all-cause mortality. Researchers found that nearly 5 percent of patients admitted at designated stroke centers used thrombolytic therapy (a technique used to dissolve blood clots) compared to less than 2 percent of patients at non-designated hospitals.

To test if the findings were specific to stroke, the researchers also compared mortality for patients who were admitted to designated stroke centers and non-designated hospitals after suffering a gastrointestinal hemorrhage or heart attack. Researchers said the outcome differences were specific for stroke.

"Even though the differences in outcomes between stroke centers and non-designated hospitals were modest, our study suggests that the implementation and establishment of a BAC-recommended stroke system of care was associated with improvement in some outcomes for patients with acute ischemic stroke," the authors wrote.

SOURCE: JAMA, January 26, 2011