Annals of Emergency Medicine
Volume 54, Issue 3 , Pages 319-327 , September 2009

A Regional System of Stroke Care Provides Thrombolytic Outcomes Comparable With the NINDS Stroke Trial

  • Marian P. LaMonte, MD, MSN

      Affiliations

    • Department of Neurology, University of Maryland School of Medicine, Baltimore, MD
    • Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD
    • Corresponding Author InformationAddress for correspondence: Marian P. LaMonte, MD, MSN, Division of Neurology, St. Agnes Hospital, 3421 Benson Avenue, Suite 240, Baltimore, MD 21227; 410-368-8444, fax 410-368-8432
    • ,
  • Mona N. Bahouth, MSN, CRNP

      Affiliations

    • University of Maryland School of Nursing and the University of Maryland Medical Center, Baltimore, MD
    • ,
  • Laurence S. Magder, PhD

      Affiliations

    • Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD
    • ,
  • Richard L. Alcorta, MD

      Affiliations

    • Maryland Institute for Emergency Medical Services Systems, Baltimore, MD
    • ,
  • Robert R. Bass, MD

      Affiliations

    • Maryland Institute for Emergency Medical Services Systems, Baltimore, MD
    • ,
  • Brian J. Browne, MD

      Affiliations

    • Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD
    • ,
  • Douglas J. Floccare, MD, MPH

      Affiliations

    • Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD
    • Maryland Institute for Emergency Medical Services Systems, Baltimore, MD
    • ,
  • Wade R. Gaasch, MD

      Affiliations

    • Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD
    • ,
  • Emergency Medicine Network of the Maryland Brain Attack Center

Received 17 July 2007 ,Revised 25 August 2008 ,Accepted 23 September 2008.

References 

  1. National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995;333:1581–1587
  2. Akins PT, Delemos C, Wentworth D, et al. Can emergency department physicians safely and effectively initiate thrombolysis for acute ischemic stroke?. Neurology. 2000;55:1801–1805
  3. Egan R, Lutsep HL, Clark WM, et al. Open label tissue plasminogen activator for stroke: the Oregon experience. J Stroke Cerebrovasc Dis. 1999;8:287–290
  4. Koennecke H, Nohr R, Leistner S, et al. Intravenous tPA for ischemic stroke team performance over time, safety, and efficacy in a single center, 2-year experience. Stroke. 2001;32:1074–1078
  5. Szoeke CE, Parsons MW, Butcher KS, et al. Acute stroke thrombolysis with intravenous tissue plasminogen activator in an Australian tertiary hospital. Med J Aust. 2003;178:324–328
  6. Asimos AW, Norton J, Price MF, et al. Therapeutic yield and outcomes of a community teaching hospital code stroke protocol. Acad Emerg Med. 2004;11:361–370
  7. Katzan IL, Furlan AJ, Lloyd LE, et al. Use of tissue plasminogen activator for acute ischemic stroke: the Cleveland area experience. JAMA. 2000;283:1151–1158
  8. Albers GW, Bates VE, Clark WM, et al. Intravenous tissue type plasminogen activator for treatment of acute stroke (The Standard Treatment With Alteplase to Reverse Stroke (STARS) Study). JAMA. 2000;289:1145–1150
  9. Wang DZ, Rose JA. Treating acute stroke patients with IV tPA (OSF Network). Stroke. 2000;31:77–81
  10. Grotta JC, Burgin WS, El-Mitwalli A, et al. Intravenous tissue-type plasminogen activator therapy for ischemic stroke: Houston experience 1996 to 2000. Arch Neurol. 2001;58:2009–2013
  11. Lopez-Yunez AM, Bruno A, Williams LS, et al. Protocol violations in community-based rTPA stroke treatment are associated with symptomatic intracerebral hemorrhage. Stroke. 2001;32:12–16
  12. Katzan IL, Hammer MD, Furlan AJ, et al. Quality improvement and tissue-type plasminogen activator for acute ischemic stroke: a Cleveland update. Stroke. 2003;34:799–800
  13. Hill MD, Buchan AM. Thrombolysis for acute ischemic stroke: results of the Canadian Alteplase for Stroke Effectiveness Study. CMAJ. 2005;172:1307–131210
  14. Dick AP, Straka J. IV tPA for acute ischemic stroke: results of the first 101 patients in a community practice. Neurologist. 2005;11:305–308
  15. Deng YZ, Reeves MJ, Jacobs BS, et al. IV tissue plasminogen activator use in acute stroke: experience from a statewide registry. Neurology. 2006;66:306–312
  16. LaMonte MP, Bahouth MN, Hu P, et al. Telemedicine for acute stroke: triumphs and pitfalls. Stroke. 2003;34:725–728
  17. Bahouth MN, LaMonte MP. The role of an acute stroke nurse practitioner: practice outcomes [abstract]. Stroke. 2006;37:746
  18. Merino JG, Lattimore SU, Warach S. Telephone assessment of stroke outcome is reliable. Stroke. 2005;36:232–233
  19. Gencheva E, Sloan M, Leurgans S, et al. Attrition and non-compliance in secondary stroke prevention trials. Neuroepidemiology. 2004;23:61–66
  20. LaMonte MP, Yarbrough KL, Bahouth MN, et al. Outcome of patients transported by air versus ground to a university stroke treatment center. Presented at: 32nd Annual Critical Care Congress; January 30, 2003; San Antonio, TX.
  21. Alberts MJ, Latchaw RE, Selman WR, et al. Recommendations for comprehensive stroke centers: a consensus statement for the Brain Attack Coalition. Stroke. 2005;36:1597–1618

 Supervising editor: Robert Silbergleit, MD

 The article was copyedited by Linda J. Kesselring, MS, ELS, the technical editor/writer in the Department of Emergency Medicine at the University of Maryland School of Medicine.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.

 Publication date: Available online December 19, 2008.

 Earn CME Credit: Continuing Medical Education is available for this article at: www.ACEP-EMedHome.com.

 Reprints not available from the authors.

 Dr. LaMonte is currently affiliated with the Division of Neurology, St. Agnes Hospital, Baltimore, MD.

PII: S0196-0644(08)01786-1

doi: 10.1016/j.annemergmed.2008.09.022

Annals of Emergency Medicine
Volume 54, Issue 3 , Pages 319-327 , September 2009

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