Ischemic Stroke - Hennepin County Medical Center

News Notes
News Notes
Analysis reveals most
common barriers to rapid
stroke treatment
The overwhelming majority of ischemic
stroke patients don’t receive the lifesaving,
disability-preventing drug,
tPA, says a report published in the
August 2008 issue of Stroke: Journal
of the American Heart Association.
The analysis, which included data on
more than 15,000 patients at hospitals
enrolled in the North Carolina
Stroke Registry, found some of the
most common reasons patients don’t
receive tPA are:
Patients don’t seek care in time.
TPA and other clot-busting drugs
must be given within three hours
of symptom onset and a CT scan
must be performed in advance of
drug administration. More than
75% of stroke patients do not
seek care within two hours of
symptom onset, which would
provide hospitals with sufficient
time to conduct the exam and
testing necessary before tPA may
be administered.
Hospitals do not provide rapid
CT scans. Guidelines from the
National Institute of Neurological
Disorders and Stroke (NINDS)
recommend CT scans be provided
within 25 minutes of arrival of
potential stroke patients but hospitals
typically do not meet this
goal. Of the 25% of stroke
patients who arrive at the hospital
within two hours after symptom
onset, less than 1/4 receive a CT
scan within 25 minutes.
Other findings of the analysis included:
Patients arriving via ambulance
were more likely to receive a
timely CT scan than those who
self-transported. Approximate half
of patients used emergency medical
services to transport.
Patients receiving care at primary
stroke centers (a designation
created by the Joint
Commission) were more likely to
receive a timely CT scan.
The achievement of timely CT
scans was not related to factors
such as health insurance status,
race, time of day, and
weekend vs. weekday arrival.
However, women were found to
be less likely to receive timely CT
scans than men.
_____________________________
Team releases data on stroke
treatment times at 2008
International Stroke Conference
The stroke team at Hennepin County
Medical Center has released data
showing that after their dedicated
stroke team was implemented,
ischemic stroke patients were treated
more frequently with IV tPA and
received IV tPA more quickly.
The data were presented by Gustavo
Rodriguez, MD, at the 2008
International Stroke Conference in
New Orleans, LA. According to the
presentation, during 2005 the following
interventions were put into place:
Approaches in Critical Care | December 2008 | 19