04:53pm Tuesday 22 October 2019

Stroke Centers Reduce Risk of Dying, Rutgers Study Finds

You are more likely to survive a hemorrhagic stroke if you are treated at a comprehensive stroke center, according to a new Rutgers and Robert Wood Johnson University Hospital study.

Photo: Courtesy of National Institutes of Health
Hemorrhagic stroke, which causes bleeding in or around the brain, has a mortality rate of 40 to 50 percent.

The research published in the Journal of the American Heart Association indicates that patients – including those transferred within 24 hours from other hospitals – from a brain bleed were more likely to survive if they were cared for at such a facility.

“Hemorrhagic stroke is complex and requires skilled medical interventions to improve a patient’s outcome,” said James S. McKinney, assistant professor of neurology at Rutgers Robert Wood Johnson Medical School and medical director of the Comprehensive Stroke Center at Robert Wood Johnson University Hospital and lead author of the study. “Based on the evidence presented in our study, we believe that more patients can survive hemorrhagic stroke with better utilization of the state’s comprehensive stroke centers.”

Stroke is a leading cause of death and disability in the United States, according to the American Heart Association and American Stroke Association.  Previous research had shown that comprehensive stroke centers improved clinical outcomes and reduced disparities in ischemic stroke caused by a blockage in blood vessels. The same may be true for patients who experience hemorrhagic stroke which causes bleeding in or around the brain and has a mortality rate of 40 to 50 percent.

The researchers reviewed more than 36,000 anonymous patient records from 1996 to 2012, including admissions and discharge data for 87 New Jersey hospitals, each designated as a comprehensive stroke center, primary stroke center or non-stroke center, by the New Jersey Department of Health and Human Services. Their findings indicate that the neurosurgical and endovascular treatments that are available at state-designated comprehensive stroke centers are associated with lower mortality rates in patients with hemorrhagic stroke.

There are 13 designated comprehensive stroke centers in New Jersey which must be staffed 24-hours-a-day, seven-days-a-week, with a neurosurgical team including diagnostic and interventional neuroradiologists. However, despite this availability, the study noted that only 40 percent of patients were admitted to a comprehensive stroke center during the study time period from 1996 to 2012, while the remaining 60 percent were admitted to either a primary stroke center or non-stroke center said McKinney.

According to McKinney, variables other than comprehensive treatment contributed to improved outcomes, including age. “In our analysis, patients admitted to comprehensive stroke centers were, on average, five years younger than patients admitted to other hospitals,” he said. “In addition, patients transferred to comprehensive stroke centers were significantly younger in age than patients who remained in primary stroke or non-stroke centers.”

The research team, all members of the Cardiovascular Institute of New Jersey, included Jerry Q. Cheng, assistant professor of medicine; Igor Rybinnik, assistant professor of neurology; and John B. Kostis, John G. Detwiler Professor of Cardiology, associate dean for Cardiovascular Research and director, Cardiovascular Institute of New Jersey. The study was funded, in part, by the Robert Wood Johnson Foundation.

For media inquiries, contact Jennifer Forbes at 732-235-6356 or jenn.forbes@rwjms.rutgers.edu.

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