Certified stroke centers more likely to administer clot-busting treatment for strokes

Certified Primary Stroke Centers are three times more likely to administer clot-busting treatment for strokes than non-certified centers, reports a new study by researchers in the Perelman School of Medicine at the University of Pennsylvania. The study, published in the Journal of the American Heart Association, looked at a wide sample of hospitals across the United States, and provides insight into practice across the US health care system as experts examine ways to increase the use of this important therapy.

Clot busting treatment is used to open blocked blood vessels, restoring blood flow to the brain and reducing disability after stroke. Less than half of ischemic stroke patients who are eligible for the treatment, recombinant tissue plasminogen activator (rt-PA), actually receive it. Currently, only a small percentage of stroke patients receive rt-PA therapy.

"We found that primary stroke centers administered rt-PA at a much higher rate than other hospitals, demonstrating one way that certified centers are succeeding." said Michael T. Mullen, MD, the study's lead author and an assistant professor of Neurology at the Perelman School of Medicine at the University of Pennsylvania.

Primary Stroke Centers, certified through The Joint Commission, used rt-PA in 6.7 percent of cases, whereas non-certified centers used the drug 2.2 percent of the time. The study also found that, between 2004 and 2009, the annual percentage of rt-PA administration increased from 1.4 percent to 3.3 percent at non-PSCs and 6.0 percent to 7.6 percent at PSCs.

National goals aim to reduce stroke mortality by 20 percent and increase appropriate use of thrombolytic therapy for acute stroke, as part of Healthy People 2020, a report of the US Department of Health and Human Services which highlights the nation's 10 year goals for health promotion and disease prevention. "Although it is encouraging to see higher treatment rates at primary stroke centers, we are still not getting this important therapy to enough stroke patients. People need to know the signs of a stroke, know to call 911, and quickly get to a hospital that is prepared to treat them," said Dr. Mullen.

"Given the impact of the primary stroke center model in the use of rt-PA, we need to measure and expand access to stroke care in the US," said the study's senior author Brendan Carr, MD, MA, Assistant Professor of Emergency Medicine, Surgery, & Epidemiology in the Perelman School of Medicine at the University of Pennsylvania. "For serious unplanned events like stroke, the goal is to make sure that all Americans have the ability to promptly reach optimal care."