Hospital mortality was highest among patients suffering hemorrhagic strokes, caused by blood leaking into the brain tissue.
Dr. Brian Silver, a stroke neurologist at Henry Ford Hospital in Detroit, said the study provides powerful evidence that the protocols can save lives and urged all hospitals that treat stroke patients to implement the guidelines.
"A lot of physicians advocate for stroke patients being directed to centers that apply these measures, with the implication that if you go to a center that applies these evidence-based guidelines, your outcomes will be improved," Silver said. "We didn't have data to show that before, but now that we have the data it can be a powerful argument that will motivate hospitals to improve their practice in order to improve outcomes."
Already, several states have legislation pending that would require stroke patients to be taken to hospitals best equipped to treat them, while Medicare now requires hospitals submitting claims to report if they participate in a database registry for stroke care. Medicare will require more detailed reporting on stroke performance measures in upcoming years, Fonarow said.
The American Heart Association has more on the Get With The Guidelines program.
SOURCES: Gregg Fonarow, M.D., professor, cardiovascular medicine, University of California, Los Angeles; Brian Silver, M.D., spokesman, American Stroke Association, and stroke neurologist, Henry Ford Hospital, Detroit; Feb. 22, 2010, Circulation: Cardiovascular Quality and Outcomes, online
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