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New research could save lives and millions of dollars
October 23, 2008The Hunter Medical Research Institute (HMRI) Stroke Research Group has developed a system to fast track stroke treatment which could benefit thousands of Australian stroke patients and save millions of dollars annually.
The system (called the Pre-hospital Acute Stroke Triage or PAST Protocol) reduces pre-hospital and emergency department delays to allow more stroke patients to receive brain saving thrombolysis or clot busting treatment within the three hour treatment window.
Results of the Australian-first trial conducted at John Hunter Hospital, New South Wales, are published in the latest Medical Journal of Australia.
"By reversing the crippling effects of stroke we are enabling more people to return to their families, their homes and their jobs. This also reduces the demand on nursing home beds, in-hospital rehabilitation programs and the health care dollar," said lead investigator Debbie Quain, a member of the HMRI Stroke Research Group and a Hunter New England Health Stroke Research Nurse.
As a result of the protocol, the number of patients treated with thrombolytic therapy at John Hunter Hospital rose from 4.7 per cent to 21.4 per cent. Of those treated, 43 per cent had minimal or no disability three months after the stroke.
Currently, less than 1 per cent of patients who have experienced an ischaemic stroke receive thrombolysis treatment in Australia. The world best practise rate is 15 to 20 per cent.
"If the PAST protocol is implemented nationally, an additional 2,500 patients could receive thrombolysis treatment each year and an estimated cost saving of $31.2 million dollars per annum will be realised," said Associate Professor Chris Levi, Head of the HMRI Stroke Research Group and Director of Acute Stroke Services at John Hunter Hospital.
The protocol equips ambulance officers with a stroke assessment tool to more accurately identify patients who may benefit from clot busting treatment, gives the ambulance control officer phone contact with a stroke neurologist to identify 'out of area' patients who may be eligible for treatment, and allows an on-call acute stroke team to respond and provide immediate care for the patient on arrival at hospital.
Stroke affects 53,000 people in Australia each year.
Research Australia
"By reversing the crippling effects of stroke we are enabling more people to return to their families, their homes and their jobs. This also reduces the demand on nursing home beds, in-hospital rehabilitation programs and the health care dollar," said lead investigator Debbie Quain, a member of the HMRI Stroke Research Group and a Hunter New England Health Stroke Research Nurse.
As a result of the protocol, the number of patients treated with thrombolytic therapy at John Hunter Hospital rose from 4.7 per cent to 21.4 per cent. Of those treated, 43 per cent had minimal or no disability three months after the stroke.
Currently, less than 1 per cent of patients who have experienced an ischaemic stroke receive thrombolysis treatment in Australia. The world best practise rate is 15 to 20 per cent.
"If the PAST protocol is implemented nationally, an additional 2,500 patients could receive thrombolysis treatment each year and an estimated cost saving of $31.2 million dollars per annum will be realised," said Associate Professor Chris Levi, Head of the HMRI Stroke Research Group and Director of Acute Stroke Services at John Hunter Hospital.
The protocol equips ambulance officers with a stroke assessment tool to more accurately identify patients who may benefit from clot busting treatment, gives the ambulance control officer phone contact with a stroke neurologist to identify 'out of area' patients who may be eligible for treatment, and allows an on-call acute stroke team to respond and provide immediate care for the patient on arrival at hospital.
Stroke affects 53,000 people in Australia each year.
Research Australia
Thrombolysis Current Events and Thrombolysis News RSSWhen seconds count: Interventional radiology treatment for pulmonary embolism saves lives
Catheter-directed therapy or catheter-directed thrombolysis-an interventional radiology treatment that uses targeted image-guided drug delivery with specially designed catheters to dissolve dangerous blood clots in the lungs-saves lives and should be considered a first-line treatment option for massive pulmonary embolism, note researchers in the November Journal of Vascular and Interventional Radiology.
Stanford study recommends change in treating pulmonary embolisms
William Kuo, MD, was the on-call interventional radiologist one Friday night three years ago when he received a call from the intensive care unit at Stanford Hospital & Clinics.
Image-guided treatment for deep venous thrombosis could improve patients' long-term outcomes
Deep Venous Thrombosis (DVT) is a serious condition that involves the formation of a blood clot inside of a deep vein usually in the legs. A patient with DVT is typically treated with anticoagulants (blood thinners) however researchers have found that image-guided interventional radiology procedures may play a more central role in the long-term treatment of DVT.
Stent for life initiative
Primary angioplasty (with stent implantation) is the most effective therapy for acute myocardial infarction (AMI), but it is not available to many patients, even though most European countries have sufficient resources (ie, catheterisation laboratories) for its wider use.
New strategies for reperfusion therapy
A new trial has begun in order to ascertain once and for all whether the best strategy for patients who cannot receive P-PCI is early fibrinolysis, together with mandated angiography.
Research highlights new approaches to prevent blood clots
Blood clotting, or coagulation, is an important process that prevents excessive bleeding when a blood vessel is injured.
Dual treatment for stroke leads to improved recovery rates, reduced mortality
It appears that stroke patients who receive both intravenous thrombolysis - a minimally invasive treatment that dissolves abnormal blood clots - and endovascular interventions - such as drugs and implanting medical devices - are much more likely to recover and have lower chances of dying.
Heart and stroke death rates steadily decline; risks still too high
In an appropriate prelude to American Heart Month, which is just ahead in February, new mortality data from the Centers for Disease Control and Prevention (CDC) shows that, since 1999, coronary heart disease and stroke age-adjusted death rates are down by 25.8 percent and 24.4 percent, respectively.
Diabetes appears to increase risk of death for patients with acute coronary syndromes
Individuals with diabetes and acute coronary syndromes (ACS) such as a heart attack or unstable angina have an increased risk of death at 30 days and one year after ACS, compared with ACS patients without diabetes.
Stem cells decrease ischemic injury and restore brain function
This is the impressive result of a study carried out by a group of researchers coordinated by Dr. Maria Grazia De Simoni of the Mario Negri Institute in Milan, Italy in cooperation with the Istituto Neurologico Besta (Milan) and the University of Lausanne.
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