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Use of tPA for ischemic stroke nearly doubled from 2003 to 2011
Date:8/21/2013

treatment, share information with other member hospitals and measure their performance. The current study analyzed data on the treatment of 1.09 million acute ischemic stroke patients at 1,683 GWTG-S hospitals during the nine-year study period.

Among all patients who were admitted to the participating hospitals for ischemic stroke, usage of tPA increased from 4 percent in 2003 to 7 percent in 2011. In patients who arrived early and were without medical conditions that would prevent safe use of the drug, tPA administration increased from 43 percent to 77 percent. Since the researchers only analyzed data for patients arriving within 2 hours of symptom onset, the increased tPA usage was not due to expansion of the time window.

Study results also indicated more use of tPA to treat patients with less serious stroke symptoms, those aged 80 and over, and for black, Hispanic and other nonwhite patients. "We expect that this expansion happened because, as providers get comfortable using this drug and seeing good patient outcomes, they become more willing to treat all eligible patients and not just those they feel are the 'cream of the crop' for treatment," explains Schwamm, who also serves as the chair of the GWTG-S Clinical Workgroup.. He adds that, while it's possible that hospitals choosing to join GWTG-S might be more likely than others to offer the most advanced stroke treatment, the program has grown to the point where many U.S. patients have access to a GWTG-S hospital.

Despite the expansion in tPA usage revealed by the study, Schwamm stresses, the drug is still underutilized. "We should be providing intravenous tPA to all eligible patients, which means that nearly a quarter of them are still missing that opportunity. Patients and their loved ones need to recognize the signs of a stroke and get to the hospital quickly by calling 911, and hospitals need to be ready to provide rapid diagnosis and treatment. We hope that our results
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Contact: Cassandra Aviles
cmaviles@partners.org
617-724-6433

Sue McGreevey
smcgreevey@partners.org
617 724-2764

Massachusetts General Hospital
Source:Eurekalert


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