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Stroke center admission linked with improved mortality, thrombolytic-therapy use
Xian Y. JAMA. 2011;305:373-380.
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Patients admitted to stroke centers for acute ischemic stroke had lower 30-day all-cause mortality and more frequently used thrombolytic therapy when compared with nondesignated hospitals, new data have shown.
“Previous evaluations of stroke center quality performance have primarily focused on process measures with limited information on patient outcomes,” the researchers wrote. “Even though the differences in outcomes between stroke centers and nondesignated hospitals were modest, our study suggests that the implementation and establishment of a [Brain Attack Coalition]-recommended stroke system of care was associated with improvement in some outcomes for patients with acute ischemic stroke.”
Researchers of the observational study collected data from the New York Statewide Planning and Research Cooperative System and compared mortality for patients admitted with acute ischemic stroke (n=30,947) between 2005 and 2006 at designated stroke centers (n=15,297) and nondesignated hospitals (n=15,650).
At 30 days, researchers found that patients admitted to stroke centers had lower all-cause mortality (10.1% vs. 12.5%; P<.001) and were more likely to use thrombolytic therapy (4.8% vs. 1.7%; P<.001) compared with those admitted to nondesignated hospitals. Statistically significant differences were also observed with mortality at 1-day, 7-day and 1-year follow-up.
To determine whether the findings were specific to stroke, researchers also tested 30-day all-cause mortality rates of patients with gastrointestinal hemorrhage and acute MI at designated and nondesignated centers and found that the outcomes were similar.
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