title: Implementation of a stroke code system in Mobile, Alabama. Diagnostic and therapeutic yield.
abstract: OBJECTIVE
  There is now therapy of proven benefit for acute ischemic stroke. Successful interventional therapy for stroke patients requires implementation of a system that facilitates rapid triage and diagnostic evaluation.
  
  
  METHODS
  We initiated a 24-hour, 7-day-per-week stroke code system at the University of South Alabama Hospitals and prospectively collected data from the first 100 patients whose clinical presentations triggered this system.
  
  
  RESULTS
  Seventy-eight patients (78%) had acute ischemic stroke. Of the remaining 22, 9 had evidence of intracerebral hemorrhage. The most common nonstroke diagnosis was seizure (n = 5). Forty-eight of the 87 stroke patients (55%) presented within 6 hours of stroke onset (40/78 = 51% of the ischemic stroke patients), and 35 of the 87 (40%) presented within 3 hours of onset (28/78 = 36% of the ischemic stroke patients). Thirty-one (31% of the group overall; 40% of the ischemic stroke patients) were eligible for acute therapy. Twenty-five of these eligible patients were entered into a treatment study, 4 declined participation, and 2 were treated with open-label tissue plasminogen activator.
  
  
  CONCLUSIONS
  Implementation of a stroke code system may result in a high yield of patients with acute stroke and relatively few "stroke mimickers." A significant proportion of all cases generated will be eligible for acute treatment under current experimental protocols or with tissue plasminogen activator, but the majority will not.
authors.affiliation: University of South Alabama Stroke Center, Mobile 36617, USA. rzweifle@jaguar1.usouthal.edu
authors.forename: R M
authors.initials: RM
authors.lastname: Zweifler
authors.forename: R
authors.initials: R
authors.lastname: Drinkard
authors.forename: S
authors.initials: S
authors.lastname: Cunningham
authors.forename: M L
authors.initials: ML
authors.lastname: Brody
authors.forename: J F
authors.initials: JF
authors.lastname: Rothrock
mesh_terms: D002545:Brain Ischemia / Q000150:complications; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D014218:Triage