More on stroke guidelines

April 1, 2006

Despite systemic challenges in caring for stroke patients, a care program developed by the American Stroke Assn. has shown promise in improving outcomes.

Despite systemic challenges in caring for stroke patients, a care program developed by the American Stroke Assn. has shown promise in improving outcomes.

Hospitals employing the American Stroke Association's Get With the Guidelines (GWTG) voluntary hospital-based stroke intervention program experienced better outcomes during a two-year study period, according to a study presented at the International Stroke Conference in February.

GWTG focuses on nine interventions that reduce complications and prolong life after stroke. Immediate interventions include the use of tissue plasminogen activator (tPA), a clot-busting drug, intravenously within three hours of symptom onset, and administering antithrombotics, such as aspirin, within 48 hours of stroke onset.

What's more, the improvements were sustained over a two-year period.

"GWTG is a series of metrics of the kind of care that should be presented when treating a stroke patient," explains Lee Schwamm, MD, associate professor of neurology at Harvard Medical School and director of Acute Stroke Services at Massachusetts General Hospital, the study's lead author. "It's a way of delivering evidence-based medicine in a systematic way."

Among the improvements noted: at the end of one year in the GTWG program, the percentage of eligible patients arriving at the sample hospitals within two hours of stroke onset who received clot-busting medication nearly doubled, increasing from 27.6% at baseline to 51%. Despite the increase in tPA usage, the rate of complications from the treatment did not increase.

The study likewise noted: