Outcomes of studies detail benefits of designation.
There are some key components of primary stroke centers that appear to make a big difference. Acute stroke teams reduce time delays and increase treatment by IV tissue plasminogen activator (TPA). Stroke units have repeatedly been shown to improve outcomes, reduce deaths, and reduce complications. Care protocols improve the efficiency of care, improve outcomes, and reduce mistakes.
A meta-analysis of data from 18 well-done, relevant studies showed that stroke unit care was associated with a significant 21% reduction in death and a 13% reduction in the combined end point of death or poor outcome.
A separate 2005 study by Dr. S. Claiborne Johnston and associates of 16,853 patients with acute ischemic stroke at 34 medical centers looked at whether the Brain Attack Coalition’s criteria for stroke centers improved care. Use of an acute stroke team reduced the risk of mortality by 24%. Emergency medical services (EMS) activation of a stroke team reduced mortality risk by 19%. The rate of TPA use at centers that had the most characteristics of primary stroke centers was close to 5% of strokes – double the rate at other centers (Neurology 2005;64:422-7).