Author Interviews, JAMA, Stroke, UCLA / 24.04.2014
Stroke: More Patients Getting Faster Treatment, Fewer Complications
MedicalResearch.com Interview with:
Dr. Gregg C. Fonarow MD
Director, Ahmanson-UCLA Cardiomyopathy Center
Professor, Department of Medicine
Associate Chief, Cardiology
David Geffen School of Medicine Los Angeles, CA
MedicalResearch.com: What are the main findings of the study?
Dr. Fonarow: This study examined data from hospitals that have adopted the American Heart Association/ American Stroke Association’s national quality initiative, Target: Stroke, which aims to increase the number of stroke patients treated with clot-busting drugs for ischemic stroke within 60 minutes or less after hospital arrival. Initiated nationwide in 2010, Target: Stroke provided 10 key strategies as well as tools to facilitate timely tPA administration, as well as additional approaches to improve stroke care and outcome.
Data from 71,169 tPA-treated stroke patients at 1,030 hospitals participating in Target: Stroke were analyzed to compared the time to treatment and incidence of complications before implementation, from 2003 to 2009, to the post-implementation years, from 2010 to 2013.
This study found that the percentage of patients treated within the recommended timeframe increased from less than one-third before Target: Stroke to more than half afterwards. The Target: Stroke program goal of 50 percent or more of patients having door-to-needle times within 60 minutes was successfully achieved. In addition, the average time to treatment dropped by 15 minutes, from 74 to 59 minutes.
Faster treatment was associated with lower rates of complications, including death. Before Target: Stroke, 9.9% of stroke patients died in the hospital, compared to 8.3% of patients treated after the initiative started, a difference which was statistically significant. In addition, patients treated by Target: Stroke strategies were less likely to develop the complication of symptomatic intracranial hemorrhage.
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