Acute Stroke Centers Could ‘Revolutionize’ Stroke Care Services

The growth of acute stroke care centers and systems of care could revolutionize 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 specialized stroke services across the world have been effective in improving acute and long-term outcomes for patients.

Acute evaluation and management of ischemic stroke-1 - Introduction
Distance Education for Acute evaluation and management of ischemic stroke-1

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.

Animation on Coronary Artery Bypass Surgery (CABG)
Coronary Artery Bypass Surgery (CABG) is performed to restore the blood supply to areas of heart that have been reduced or has no blood supply due to blockage in the artery.

Early management of patients with this form of stroke is aimed at minimizing 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 organized stroke care and primary stroke centers – specialized facilities which coordinate and promote patient access to the full range of treatments and services associated with stroke prevention, treatment and rehabilitation.

“Rapid Access” to Minor Stroke Clinics Takes Twice as Long as It Should
“Rapid access” to minor stroke clinics takes twice as long as it should, suggests research published ahead of print in the Journal of Neurology Neurosurgery and Psychiatry.

These centers (similar to specialist stroke centers in the UK) can provide emergency medical services for first-line response and initial stabilization; 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 centers and systems of care may revolutionize the medical community’s ability to treat patients with stroke. Specialized stroke services have been effective in improving acute and long-term care outcome measures.

Mini-Stroke Patients Get Better Care In Hospitals With Stroke Services
Patients who suffer from transient ischemic attack (so-called “mini-strokes”) are more likely to receive rapid assessment and care if they attend a hospital, which has organized stroke care services.

“Focusing clinical resources 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.”

Source-BMJ
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