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Excellent Stroke Care Throughout the Week

Posted on January 18, 2010

Recently Dr. Lopes, endovascular neurosurgeon at Rush University Medical Center, read a story in the LA Times discussing a new study published in the January 2010 issue of Archives of Neurology. This study reviewed the impact the day of week has on the speed in which a stroke patient receives treatment. Defying general logic, it turns out that this study reveals that stroke treatment in the U.S. is MORE aggressive on the weekends, than during the week.

Researchers at the Medical University of South Carolina in Charleston analyzed the records of nearly 80,000 patients who were treated for acute ischemic stroke – which occurs when a blood clot or other obstruction cuts off blood supply to the brain – in Virginia between 1998 and 2006. Patients who were admitted on the weekend were 20% more likely to receive the clot-busting drug tissue plasminogen activator, also known as tPA, than were patients who suffered strokes on weekdays.

Unlike the experience in Virginia, patients presenting for acute stroke treatment at Rush University Medical Center, a designated stroke center in Illinois with well established clinical and operational protocols, will find that day of week has no bearing on the excellent advanced stroke care they will receive. And they have the data to prove it.

Over the past eight years, Dr. Lopes has worked with his physician colleagues and administrators at Rush to develop one of the most well respected acute stroke centers in the country. Rush is renowned for the advanced acute stroke care it offers patients. One important component of advanced stroke care is the ability to deliver clot busting drugs directly to the site of the clot or to use clot retrieval devices to pull the clot out of the narrowed blood vessels. These types of therapies are referred to as endovascular revascularization therapies (ERT). These therapies can be delivered beyond the three hour window allowed for the more conventional IV t-PA therapy offered at many hospitals.

The physicians and researchers at Rush University Medical Center have studied in 48 consecutive patients the time in which it takes a patient presenting with acute stroke to receive advanced ERT. Study results demonstrate that it takes approximately one hour for a patient to be ready to undergo ERT in the Rush angiography suite, and this “door-to-angiography time” is not influenced by weekend or time of day, stroke severity, age, or clinical features.

If you have any questions or comments regarding this data, please share them with Dr. Lopes by commenting below or emailing him at info@ChicagoStrokeMD.com.