title: Increased use of thrombolytic therapy and shortening of in-hospital delays following acute ischemic stroke: experience on the establishment of a primary stroke center at a community hospital.
abstract: OBJECTIVE
  To improve and standardize stroke care, the establishment of primary stroke centers (PSCs) has been advised. Thrombolytic therapy has been proved to improve the outcome of acute ischemic stroke (AIS). We assessed the use of thrombolytic therapy before and after setting up a PSC at a community hospital.
  
  
  METHODS
  In November 2007, a PSC was established at our hospital. Following guidelines based on national recommendations, we administered intravenous tissue plasminogen activator (tPA) to patients who met the criteria. To study the effects of the establishment of the PSC on tPA treatment rates, we examined our database of stroke patients dating back to January 2004.
  
  
  RESULTS
  Before the establishment of the PSC, there have been 2,420 patients admitted to our hospital diagnosed with AIS. Only 1.2% of these patients were treated with intravenous tPA. Following the establishment of the PSC, 2.8% of 1151 AIS patients were treated with tPA. Time of patient arrival to patient treatment was also diminished.
  
  
  CONCLUSIONS
  The establishment of the PSC significantly increases the usage of tPA treatment. Furthermore, response time to patient cases was also quicker. However, for maximum effectiveness, the public still needs to be made more aware of the risks of stroke and the importance of seeking medical care at the first signs of stroke.
authors.affiliation: Department of Neurology, Chia-Yi Christian Hospital, Chiayi City, Taiwan. 02442@cych.org.tw
authors.forename: Sheng-Feng
authors.initials: SF
authors.lastname: Sung
authors.forename: Cheung-Ter
authors.initials: CT
authors.lastname: Ong
authors.forename: Chi-Shun
authors.initials: CS
authors.lastname: Wu
authors.forename: Yung-Chu
authors.initials: YC
authors.lastname: Hsu
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Su
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000150:complications; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data* / Q000639:trends*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D010959:Tissue Plasminogen Activator