Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, February 19, 2020

Quality of Acute Stroke Care at Primary Stroke Centers Before and After Certification in Comparison to Never-Certified Hospitals

What fucking stupidity. You don't measure 'care, you measure results; like 100% recovery. When will we get survivors in charge and actually solve stroke rather than tip toeing around the edges?

Quality of Acute Stroke Care at Primary Stroke Centers Before and After Certification in Comparison to Never-Certified Hospitals


Kristina Shkirkova1*, Theodore T. Wang2, Lily Vartanyan2, David S. Liebeskind3, Marc Eckstein4, Sidney Starkman3, Samuel Stratton5, Franklin D. Pratt6, Scott Hamilton7, May Kim-Tenser2, Robin Conwit8, Jeffrey L. Saver3 and Nerses Sanossian2 on behalf of FAST-MAG Investigators and Coordinators
  • 1Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
  • 2Department of Neurology, Roxanna Todd Hodges Comprehensive Stroke Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
  • 3Department of Neurology, UCLA Comprehensive Stroke Center, Los Angeles, CA, United States
  • 4Department of Emergency Medicine, University of Southern California, Los Angeles, CA, United States
  • 5Department of Community Health Sciences, University of California, Los Angeles, Los Angeles, CA, United States
  • 6Los Angeles County Department of Public Health, Los Angeles, CA, United States
  • 7Department of Neurology, Stanford Stroke Center, School of Medicine, Stanford University, Palo Alto, CA, United States
  • 8National Institutes of Health, Bethesda, MD, United States
Background and Purpose: 
Primary stroke center (PSC) certification is associated with improvements in stroke care and outcome. However, these improvements may reflect a higher baseline level of care delivery in hospitals eventually achieving certification. This study examines whether advancements in acute stroke care at PSCs are due to certification or factors intrinsic to the hospital.
Methods: 
Data was obtained from the Field Administration of Stroke Therapy-Magnesium (FAST-MAG) trial with participation of 40 Emergency Medical System agencies, 315 ambulances, and 60 acute receiving hospitals in Los Angeles and Orange Counties. Subjects were transported to one of three types of destinations: PSC certified hospitals (PSCs), hospitals that were not PSCs at time of enrollment but would later become certified (pre-PSCs), and hospitals that would never be certified (non-PSCs). Metrics of acute stroke care quality included time arrival to imaging, use of intravenous tPA, and arrival to treatment.
Results: 
Of 1,700 cases, 856(50%) were at certified PSCs, 529(31%) were at pre-PSCs, and 315 (19%) were at non-PSCs. Mean (SD) was 33min (±76.1) at PSCs, 47(±86.6) at pre-PSCs, and 49(±71.7) at non-PSCs. Of 1,223 cerebral ischemia cases, rate of tPA utilization was 43% at PSCs, 27% at pre-PSCs, and 28% at non-PSCs. Mean ED arrival to thrombolysis was 71(±32.7) at PSC, 98(±37.6) at pre-PSC, and 95(±45.0) at non-PSCs. PSCs had improved time to imaging (p = 0.014), percent tPA use (p < 0.001), and time to treatment (p = 0.003).
Conclusions: 
Stroke care at hospitals prior to PSC certification is equivalent to care at non-PSCs.
Clinical Trial Registration: http://www.clinicaltrials.gov. Unique identifier: NCT00059332.

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