CardiovascularAcute Stroke Centres Promise To 'revolutionise' Stroke Care Services
The growth of acute stroke care centres and systems of care could revolutionise clinicians" ability to treat patients with stroke, according to an analysis of services published ahead of print in the Journal of NeuroInterventional Surgery.
The analysis looks at how specialised stroke services across the world have been effective in improving acute and long-term outcomes for patients.
Stroke is the third largest cause of death in the US, Europe, Canada and Japan. In England, around 110,000 people experience a stroke every year and 795,000 in the US.
Researchers from the University of Texas studied how stroke services are developing and looked in particular at current and emerging therapies in acute ischemic stroke, in which a patient experiences the death of an area of brain tissue resulting from an inadequate supply of blood and oxygen to the brain due to blockage of an artery.
In ischemic stroke cases, between 50% and 70% of survivors regain functional independence, while 15-30% are permanently disabled and 20% need institutional care three months after the stroke.
Early management of patients with this form of stroke is aimed at minimising disability and improving a person"s functioning, say the researchers.
Over the past decade, new therapeutic options have become available for stroke patients, says the analysis, including organised stroke care and primary stroke centres - specialised facilities which coordinate and promote patient access to the full range of treatments and services associated with stroke prevention, treatment and rehabilitation.
These centres (similar to specialist stroke centres in the UK) can provide emergency medical services for first-line response and initial stabilisation; emergency department for hyperacute stroke care; acute stroke team availability within 15 minutes; neuroimaging and laboratory services in-house; stroke unit with treatment and secondary prevention; neurointerventional and neurosurgical services available; rehabilitation; primary prevention; community education and continuing medical education; and outcome and quality improvement activities.
The authors conclude: "The development of acute stroke centres and systems of care may revolutionise the medical community"s ability to treat patients with stroke. Specialised stroke services have been effective in improving acute and long-term care outcome measures.
"Focusing clinical res in neurocritical care units and stroke units provides greater specialist care, enhances knowledge in the field, and may also facilitate data collection and enrollment in clinical trials."
"Review of current and emerging therapies in acute ischemic stroke."
J NeuroInterv Surg 2009; doi 10.1136/jnis.2009.000117
Journal of Neurointerventional Surgery