Specialized Stroke Care Improves Outcomes
THURSDAY Nov. 20, 2008 -- Stroke patients treated at community hospitals with specialized stroke care and telemedicine support from major stroke centers are more likely to survive and live independently than patients treated at hospitals without stroke units, a German study finds.
It included 1,938 stroke patients treated at hospitals with specialized stroke care and 1,122 patients treated at other hospitals. The researchers found patients treated at hospitals with specialized stroke units had a 35 percent lower risk of death and dependency (defined as disability or need for institutional care) a year after their stroke and a 20 percent lower risk at 30 months.
"What we see is that not only does the quality of care improve very significantly, but also the subsequent prognosis of the patients. These effects are also quite stable. We can see the effects after one and two years and, at least in our trial, after two and half years," Dr. Heinrich Audebert, a stroke specialist at Charite Hospital in Berlin, said in an American Heart Association news release.
He and his colleagues said the better outcomes among patients at hospitals with specialized stroke care were associated with practices indicative of high-quality stroke care: rapid brain imaging, use of clot-dissolving drugs, assessment of stroke-related swallowing disorders, and early initiation of stroke rehabilitation.
The study was published online Nov. 20 in the journal Stroke.
It can be expensive to establish a specialized stroke unit, but these costs are recouped over time through savings related to shorter hospitalization and less disability, Audebert said.
Due to a shortage of experienced physicians and lack of access to stroke-related clinical expertise at major medical centers, many community hospitals don't have dedicated stroke units, according to background information in the news release. Rural hospitals, in particular, often lack the resources to provide specialized stroke care. However, telemedicine can expand the reach of specialized acute care services to the majority of hospitals, regardless of location. In telemedicine, communication links are used to transmit and receive data and information at remote locations.
The U.S. National Institute of Neurological Disorders and Stroke has more about stroke.
Posted: November 2008
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