Giving clot busters within three hours of symptom onset can reduce disability from stroke. But many of today's health systems don't have the stroke response system in place to quickly recognize, diagnose and provide therapy to patients who suffer stroke. As a result, only 2 percent to 3 percent of eligible patients receive the approved clot-busting therapy, called tissue plasminogen activator (tPA).
In the first study, Toby Gropen, M.D., chairman of the department of neurology, Long Island College Hospital, Brooklyn, N.Y., and chair of the New York City Operation Stroke, and colleagues studied 32 hospitals in Brooklyn and Queens, New York City.
Fourteen of the hospitals were designated as Brain Attack Coalition Primary Stroke Centers, a model that requires that centers meet the Brain Attack Coalition (BAC) guidelines that include acute stroke teams available to respond 24 hours a day, seven days a week; a specialized unit dedicated to stroke care; appropriate laboratory services; and an experienced staff, which undergoes regular continuing medical education.
The BAC is a group of professional, voluntary and government organizations including the American Stroke Association. In 2000, the coalition published guidelines on establishing primary stroke centers to improve care of stroke patients and standardize some aspects of acute stroke care.
From March to May 2002, researchers examined data from 763 ischemic stroke patients at the start of the study, before the hospitals received designation, and re-measured the data for 725 ischemic stroke patients after the hospitals were designated.