Expanded modes of tissue plasminogen activator delivery in a comprehensive stroke center increases regional acute stroke interventions.
OBJECTIVE
We sought to evaluate whether a comprehensive stroke center could work with regional hospitals to increase the use of tissue plasminogen activator (tPA) in acute stroke.


METHODS
In 30 months, 142 patients seen at the Mid America Brain and Stroke Institute received tPA. Site of presentation, protocol selection, and outcomes were analyzed.


RESULTS
We found that 18.2% (142 of 781) of all ischemic strokes received tPA. Of those, 70% (99 of 142) were transferred from hospitals within 100 miles of Kansas City (Mo). Mortality rate was 12.7% (18 of 142). Symptomatic hemorrhage rate was 9.2%.


CONCLUSIONS
A comprehensive stroke center can serve as a hub for a regional network and increase the number of stroke interventions with acceptable outcomes.
Rymer
Marilyn M
MM
UMKC School of Medicine, Mid America Brain and Stroke Institute at Saint Luke's Hospital, Room 3112, Saint Luke's Hospital, 4401 Wornall Rd, Kansas City, MO 64111, USA. mrymer@saint-lukes.org
Thurtchley
Duane
D
Summers
Deborah
D
D000208:Acute Disease; D002545:Brain Ischemia / Q000188:drug therapy / Q000401:mortality; D002543:Cerebral Hemorrhage / Q000139:chemically induced; D004333:Drug Administration Routes; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008923:Missouri; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D010360:Patient Transfer / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012041:Regional Medical Programs; D012720:Severity of Illness Index; D020521:Stroke / Q000188:drug therapy* / Q000401:mortality; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects
D010959:Tissue Plasminogen Activator