(Stroke. 1997;28:981-983.)
© 1997 American Heart Association, Inc.
Articles |
Implementation of a Stroke Code System in Mobile, Alabama
Diagnostic and Therapeutic Yield
From the University of South Alabama Stroke Center, Mobile.
Correspondence to Dr Richard M. Zweifler, USA Stroke Center, 10th Floor, Suite I, 2451 Fillingim St, Mobile, AL 36617. E-mail rzweifle{at}jaguar1.usouthal.edu
Background and Purpose There is now therapy of proven benefit for acute ischemic stroke. Successful interventional therapy for stroke patients requires implementation of a system that facilitates rapid triage and diagnostic evaluation.
Methods We initiated a 24-hour, 7-day-per-week stroke code system at the University of South Alabama Hospitals and prospectively collected data from the first 100 patients whose clinical presentations triggered this system.
Results Seventy-eight patients (78%) had acute ischemic stroke. Of the remaining 22, 9 had evidence of intracerebral hemorrhage. The most common nonstroke diagnosis was seizure (n=5). Forty-eight of the 87 stroke patients (55%) presented within 6 hours of stroke onset (40/78=51% of the ischemic stroke patients), and 35 of the 87 (40%) presented within 3 hours of onset (28/78=36% of the ischemic stroke patients). Thirty-one (31% of the group overall; 40% of the ischemic stroke patients) were eligible for acute therapy. Twenty-five of these eligible patients were entered into a treatment study, 4 declined participation, and 2 were treated with open-label tissue plasminogen activator.
Conclusions Implementation of a stroke code system may result in a high yield of patients with acute stroke and relatively few "stroke mimickers." A significant proportion of all cases generated will be eligible for acute treatment under current experimental protocols or with tissue plasminogen activator, but the majority will not.
Key Words: diagnosis • stroke, acute • stroke management • stroke onset
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