Published Online
on May 1, 2003

A more recent version of this article appeared on June 1, 2003

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Submitted on December 5, 2002
Accepted on December 23, 2002

Expanded Modes of Tissue Plasminogen Activator Delivery in a Comprehensive Stroke Center Increases Regional Acute Stroke Interventions

Marilyn M. Rymer MD^*; Duane Thurtchley RN; Deborah Summers RN, MSN; and for the Mid America Brain and Stroke Institute Stroke Team

From the UMKC School of Medicine (M.M.R.) and Mid America Brain and Stroke Institute at Saint Luke's Hospital (M.M.R., D.T., D.S.), Kansas City, Mo.

^* To whom correspondence should be addressed. E-mail: mrymer{at}saint-lukes.org.

Background and Purpose--We sought to evaluate whether a comprehensive stroke center could work with regional hospitals to increase the use of tissue plasminogen activator (tPA) in acute stroke.

Methods--In 30 months, 142 patients seen at the Mid America Brain and Stroke Institute received tPA. Site of presentation, protocol selection, and outcomes were analyzed.

Results--We found that 18.2% (142 of 781) of all ischemic strokes received tPA. Of those, 70% (99 of 142) were transferred from hospitals within 100 miles of Kansas City (Mo). Mortality rate was 12.7% (18 of 142). Symptomatic hemorrhage rate was 9.2%.

Conclusions--A comprehensive stroke center can serve as a hub for a regional network and increase the number of stroke interventions with acceptable outcomes.

Key words: stroke, ischemic • stroke units • thrombolysis • tissue plasminogen activator

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