Study shows Utah hospitals are best in the nation for stroke treatment
Mike Terry, Deseret News
SALT LAKE CITY — While a stroke can be scary and debilitating, Utahns can rest easier knowing that they'll likely receive the best immediate care.
At least 62 percent of stroke patients in the state received clot-busting medication within an hour of arriving at emergency departments statewide during 2012 — the highest percentage in the country, according to a new study by the American Heart Association and American Stroke Association.
Results were dramatically better than the national average of 43 percent, and significantly better than any other state.
"You never want to experience a stroke, but the data suggest that if you're going to have one, Utah is the best place to be in the nation," said Dr. Kevin Call, a stroke neurologist with Intermountain Healthcare.
Call said the result is directly tied to the fact that hospitals in the state work toward the same common goal, which is "to provide the fastest, best possible care for patients."
The study, released Thursday, measured "door-to-needle" time, or the amount of time it takes for medical professionals to give eligible stroke patients an intravenous dose of a complex protein intended to break down potentially harmful blood clots in the brain. The speed at which Utah patients received the recombinant tissue plasminogen activator, or rt-PA, outpaced all other states.
Colorado hospitals are the only others that came close, assisting 61.7 percent of patients in time to make a bigger difference in possible healthy outcomes. Nebraska patients experienced the greatest lag in response time, with 21.1 percent receiving the dose within an hour of admittance, the report states.
Timing is crucial in case of a stroke, as tens of thousands of brain cells die every second blood is not flowing to the brain. Delays in treatment can result in greater loss of brain functions.
Individuals who might experience or witness a stroke are encouraged to pay attention to symptoms, including weakness on one side of the body, slurring or inability to speak, sudden change in vision, inability to walk and/or a drooping side of the face. Emergency personnel should be notified as soon as possible.
National best-practice guidelines include a possible stroke patient's evaluation within 10 minutes of arrival to the emergency department or hospital. A stroke team — including at least one neurologist and nurses, as well as other emergency personnel — should be notified within 15 minutes and imaging conducted by the 25-minute mark. Scans should be interpreted within 45 minutes and rt-PA administered before an hour passes.
The IV drug dose is the "standard of care for ischemic stroke patients," Dr. Jennifer Majersik, director of the stroke center at University Hospital, said Thursday.
"It's the best way to treat them and the best way to limit the long-term disabilities from stroke," Majersik said. "The faster you get it, the sooner it works, and the more likely you are to recover from a stroke."
In Utah, 17 hospitals participate in the American Heart Association/American Stroke Association stroke-specific quality-improvement program, "Get with the Guidelines." Eight of those are large hospitals designated as primary stroke centers — Intermountain Medical Center, Jordan Valley Medical Center, McKay-Dee Hospital Center, Ogden Regional Medical Center, Pioneer Valley Hospital, St. Mark's Hospital, University Hospital and Utah Valley Regional Medical Center.
Nine other facilities have the procedures, equipment and protocols in place to provide emergency stroke care, usually in consultation with a primary stroke center.
The problem for some patients is that symptoms are often ignored until it is too late, and rt-PA must be administered within three hours of the first symptoms to be effective. The delay in stroke identification and treatment has led to it being the third leading cause of death in the United States and in Utah.
The American Heart Association and American Stroke Association also claim that stroke is perhaps the leading cause of disability, but it is treatable if caught early enough.
It is estimated that someone in the U.S. suffers a stroke every 45 seconds; someone dies of a stroke every three minutes; and 785,000 people suffer a new or recurrent stroke each year, according to the associations.
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