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'Stroke Centers' Providing Better Care, Study Finds
Date:1/26/2011

designated stroke centers, the researchers found. After 30 days, 10.1 percent of these patients died, versus 12.5 percent of patients sent to other facilities, an absolute risk reduction of 2.5 percent.

Use of clot-busting medications was 4.8 percent for stroke center patients and 1.7 percent for patients at nondesignated hospitals, meaning patients admitted to designated stroke centers were 2.2 percent more likely to receive clot-busting medications.

Improvements were seen out to one year (as far as the database extended).

Dr. Roger Bonomo, director of stroke care at Lenox Hill Hospital in New York City, noted that the improvements "started at day 1 of the stroke center being certified," meaning that greater improvements may be seen as more data is collected.

But the study only looked at one outcome, said another expert.

"It's good to know that people who make an effort to deliver evidence-based and organized care are making a difference for stroke patients," said Dr. Andrei Alexandrov, professor of neurology and director of the Comprehensive Stroke Center at the University of Alabama at Birmingham.

"The unfortunate part is that we do not have more extensive databases nationwide to look at factors other than death rate," Alexandrov said. "Death is not the worse outcome in stroke. What we would really like to know is, are we reducing the number of people with really severe disability that leaves you bedridden? That's the target."

A second study in the same issue of the journal found that the incidence of stroke following bypass operations has fallen considerably over the past three decades although Americans are at higher risk than ever for having a stroke.

After peaking in 1988 at 2.6 percent, the incidence of stroke decreased 4.69 percent per year, leaving an overall stroke rate after coronary artery bypass surgery of 1.6 percent.

Medicare reports that 1.3 percent of its beneficiaries, who are mostly
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