title: Improving Outcomes Achieved by a New Stroke Program in Hungary.
abstract: BACKGROUND
  Stroke is a devastating disease with increasing incidence and prevalence due to population aging. Even with the best care, a proportion of patients dies or is left with significant neurological and cognitive disability. Organization of stroke centers markedly improved outcomes worldwide. We initiated a 'lysis alarm' program in September 2013 at our medical center.
  
  
  METHODS
  This is a retrospective review of electronic data from patients with acute ischemic stroke before (October 2012-June 2013) and after (October 2013-June 2014) the 'lysis alarm' program was introduced at our medical center.
  
  
  RESULTS
  Prior to the introduction of the stroke program, there were only 19 thrombolysis procedures in 777 acute stroke patients in 9 months, while this figure rose to 32 thrombolysis procedures in 737 acute stroke patients after the initiation of the program. The 'door-to-needle' time decreased from 88 to 71 min when the two study periods were compared. These changes were associated with decreased stroke mortality in patients receiving thrombolytic treatment (16% prior to the program and 9% during the program). In 2013, there were 1,439 thrombolysis procedures, representing 3.2% of all stroke cases throughout Hungary. After the introduction of the 'lysis alarm' program, we have reached a 4% thrombolysis rate at our medical center.
  
  
  CONCLUSIONS
  Our thrombolysis rate is higher than the national average, but still low compared to the rates of Western European countries. We are continuously working to enhance our stroke program. Here, we discuss those components that need to be further refined in order to improve stroke intervention and outcome.
authors.affiliation: Markusovszky University Teaching Hospital, University of Pécs, Szombathely, Hungary.
authors.forename: Csilla
authors.initials: C
authors.lastname: Égi
authors.affiliation: Markusovszky University Teaching Hospital, University of Pécs, Szombathely, Hungary.
authors.forename: Júlia
authors.initials: J
authors.lastname: Horváth
authors.affiliation: Markusovszky University Teaching Hospital, University of Pécs, Szombathely, Hungary.
authors.forename: Katalin
authors.initials: K
authors.lastname: Hahn
authors.affiliation: Markusovszky University Teaching Hospital, University of Pécs, Szombathely, Hungary.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Kalman
authors.affiliation: Markusovszky University Teaching Hospital, University of Pécs, Szombathely, Hungary.
authors.forename: József
authors.initials: J
authors.lastname: Betlehem
authors.affiliation: Markusovszky University Teaching Hospital, University of Pécs, Szombathely, Hungary.
authors.forename: Lajos
authors.initials: L
authors.lastname: Nagy
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D015912:Thrombolytic Therapy / Q000379:methods* / Q000706:statistics & numerical data; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Public education; Stroke; Stroke center; Stroke team; Thrombolysis