Mark J. Alberts, MD

Disclosures

March 19, 2012

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Hello and welcome to this Medscape stroke update. My name is Dr. Mark Alberts, and I am head of the stroke program at Northwestern University in Chicago, Illinois. Today I would like to discuss several presentations from the 2012 International Stroke Conference (ISC) in New Orleans in February. At this year's stroke meeting, investigators reported results of several studies of stroke centers and how they operated in terms of improving patient care and outcomes. The conclusions from all of these studies are as follows: First, patients who are treated at certified primary stroke centers have better outcomes. Second, [patients treated at primary stroke centers] are more likely to be treated with tPA (tissue plasminogen activator); not only are the eligible patients more likely to be treated with tPA, but overall, everyone is more likely to receive tPA at a primary stroke center. Third, the longer a hospital is certified as a primary stroke center, the more likely patients there will be treated with tPA. This holds for academic centers as well as nonacademic medical centers.

Another aspect of acute stroke care that was examined at the meeting was the practice of prior notification. When an ambulance goes out to pick up a patient with suspected stroke, and emergency medical personnel call the hospital while the ambulance is on the way to say that they are bringing in a patient who likely has an acute stroke, that patient is more likely to receive more rapid and efficient care in the emergency department and in the hospital. That patient is more likely to be treated with intravenous tPA within a 3- or 4.5-hour time window.

The last point I want to make is that the Joint Commission and the American Heart Association announced at the ISC that, through a collaborative effort, they will begin a formal process for certifying comprehensive stroke centers beginning in July 2012. This is an exciting, important development because now the facilities that strive to be comprehensive stroke centers will have a pathway forward for formal certification and recognition. Again, that will begin in July 2012.

Thank you very much for listening to this Medscape stroke update.

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