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New stroke program improves treatment

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A stroke is one of the most debilitating medical conditions. It can limit one’s ability to eat, talk, or walk and dramatically reduce quality of life. A recent paper in the Journal of the American Medical Association introduces a new national program to streamline the treatment of stroke. Of note, only one Augusta-area hospital is part of this program.

A stroke occurs when the brain does not receive enough blood, often as a result of a blood clot in the brain. The best treatment for strokes caused by a clot is to give a medicine called tPA, informally known as a “clot-buster.”

Depending on which part of the brain is affected, symptoms from a stroke can vary. For example, if the area of the brain responsible for speech is affected by the stroke, one will have difficulty talking. An easy mnemonic to remember the signs of a stroke is F-A-S-T. F is for facial drooping, A is for arm weakness, S is for speech problems, and T is for the importance of time. In general, the quicker blood flow returns to the brain, the lower the chance one will have long-term problems from the stroke.

Because of the significance of time in stroke treatment, in 2010 the American Heart Association and the American Stroke Association launched a national quality improvement program to decrease the time between when a stroke patient arrives to the hospital and when the “clot-buster” is given. Key parts of the program include early warning by paramedics of a possible stroke, streamlined evaluation by a stroke doctor, and a rapid CT scan of the brain.

Dr. Gregg Fonarow, a professor of medicine at UCLA, along with researchers at Duke and Harvard, examined the success of this national quality improvement program called Target: Stroke. They analyzed data from over 40,000 stroke patients between 2010 and 2013 who were treated at hospitals that implemented Target: Stroke and compared them with stroke patients who were treated before the program. They found that patients treated under Target: Stroke were given the “clot-buster” quicker and had a significantly higher chance of survival. Patients treated under the new program were also less likely to be disabled and more likely to be discharged home.

Fonarow’s study shows that the national quality improvement program Target: Stroke is a success. Hospitals that implemented the program delivered treatment earlier and decreased the chance of death and disability for their patients.

Currently in the Augusta area, Georgia Regents Medical Center is the only hospital that participates in the Target: Stroke program. However, with the success of the program, I predict more hospitals in the area are likely to join. Patients can view which hospitals add the program on the American Heart Association Web site.

Strokes can be scary. It is important to know how to recognize them and to call 911 early. Fonarow’s study gives us hope that we can continue to improve the treatment of stroke.


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