Lucky number? Seven factors may increase clot buster use for stroke

SAN DIEGO, Feb. 6 Seven factors, including written procedures for treating stroke and a responsive emergency room staff may increase the odds that ischemic stroke patients will receive clot-busting drugs, researchers reported today at the American Stroke Association's 29th International Stroke Conference.

The preliminary information was gathered from a study of 34 academic medical institutions.

Clinical studies have shown that the clot-buster tPA (tissue plasminogen activator) can reduce the debilitating and crippling effects of stroke. However, it must be given within three hours of symptom onset.

In 2000, stroke experts comprising the Brain Attack Coalition (BAC) suggested that defining and establishing primary stroke centers should improve patient care and outcomes. They listed 11 major criteria that every primary stroke center should meet. The Coalition consists of 13 health organizations, including the American Stroke Association, a division of the American Heart Association; and the American Academy of Neurology.

However, little evidence existed in medical literature at the time to indicate which specific factors improved patient care at stroke centers, said senior author S. Claiborne Johnston, M.D., director of Stroke Services at the University of California San Francisco Medical Center.

"We wanted to see how well the Brain Attack Coalition recommendations actually predicted patient outcome and better quality of care in stroke centers," Johnston said.

"We found that seven of 11 recommended criteria increased the use of tPA. The more of these seven criteria that a center followed, the greater the use of the drug," he said.

Having written procedures for treating stroke was the strongest predictor. Three other factors significantly influenced use of tPA: integrating emergency medical personnel into the treatment effort; an emergency room staff well trained in recognizing stroke; and continuing medical education

Contact: Carole Bullock
American Heart Association

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