ArticleCirculation. Cardiovascular quality and outcomes2012
Predictors of increased intravenous tissue plasminogen activator use among hospitals participating in the Massachusetts Primary Stroke Service Program.
Article in Circulation. Cardiovascular quality and outcomes, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Neurophysiology tools to lower the stroke onset to treatment time during the golden hour: microwaves, bioelectrical impedance and near infrared spectroscopy.Annals of medicine · 2022Review
- Reasons and predictors of non-thrombolysis in patients with acute ischemic stroke admitted within 4.5 h.Acta neurologica Scandinavica · 2022Article
- Article
- Are EMS bypass policies effective implementation strategies for intravenous alteplase for stroke?Implementation science communications · 2020Article
- The American Heart Association's Get With the Guidelines (GWTG)-Stroke development and impact on stroke care.Stroke and vascular neurology · 2017Review
- Why are acute ischemic stroke patients not receiving IV tPA? Results from a national registry.Neurology · 2016Article
- The Relationships Among Regionalization, Processes, and Outcomes for Stroke Care: A Nationwide Population-based Study.Medicine · 2016Observational
- Stroke Severity Is a Crucial Predictor of Outcome: An International Prospective Validation Study.Journal of the American Heart Association · 2016Article
- Racial Disparities in Intravenous Recombinant Tissue Plasminogen Activator Use Persist at Primary Stroke Centers.Journal of the American Heart Association · 2015Article
- Development of regional stroke programs.Current neurology and neuroscience reports · 2015Review
- Telestroke in an urban setting.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2014Article
- Thrombolytic utilization for ischemic stroke in US hospitals with neurology residency program.Neurology · 2013Article
- Hyperacute management of ischemic stroke.Seminars in neurology · 2013Review
- Improving thrombolysis for acute ischemic stroke in Lombardia stroke centers.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2013Article
- When in rome, do like the Romans: certifying stroke centers with the rod of aesculapius or the medical caduceus of hermes?Journal of the American Heart Association · 2013Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundWe sought to determine if intravenous tissue plasminogen activator (IV tPA) use for acute ischemic stroke increased in Massachusetts in association with the Primary Stroke Service program, a statewide stroke center designation and quality improvement initiative. METHODS AND
resultsWe analyzed prospectively acquired data from the Massachusetts Department of Public Health between October 2004 and June 2008, including 10 045 consecutive emergency department-based acute ischemic stroke encounters arriving ≤ 3 hours after stroke onset at 69 participating Massachusetts PSS hospitals. The overall rate of IV tPA use was 854 of 3866 (22.1%) of patients arriving ≤ 2 hours of symptom onset. IV tPA use increased steadily from 2005 (the first full year of the program) to 2008 (18.4%, 21.9%, 22.6%, 25.5%; P=0.001). Patients treated with IV tPA were more likely to be younger (72.3 ± 14.1 versus 74.7 ± 14.0 years, P<0.005) and to have presented after emergency medical services rerouting in July 2005 (96% versus 94%, P=0.009). Patients who arrived at hospitals with a performance achievement award from the Get With The Guidelines-Stroke program were more likely to receive IV tPA after versus before award recognition (28.1% versus 22.3%, P<0.001).
conclusionsIn this nearly complete capture of statewide data, rates of IV tPA improved significantly in Massachusetts from 2005 to 2008 in association with a state Primary Stroke Service designation program. Further studies are needed to confirm that treatment disparities exist for older acute ischemic stroke patients and that the rates of thrombolysis have increased above and beyond secular trends.
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