'Target Stroke' Initiative Improves Stroke Patients' Treatments, Outcomes

The national initiative Target Stroke reduced rates of in-hospital mortality and intracranial hemorrhage in stroke patients, a new study shows.

Although treatment guidelines indicate intravenous tissue plasminogen activator (tPA) therapy for eligible patients within 60 minutes of arrival at the hospital, previous data suggest that less than 30 percent receive the treatment within the recommended time frame. Findings show that the initiative cut the time before acute ischemic stroke patients were treated with intravenous tPA, leading to enhanced patient outcomes. The quicker treatment was linked to an increased number of patients discharged to their homes.

Target Stroke was organized by the American Heart Association and the American Stroke Association, and was launched in January 2010. The initiative includes 10 care strategies designed to reduce door-to-needle times, offers clinical decision support tools, and facilitates participation as well as sharing of best practices among hospitals.

A study examined the portion of stroke patients treated with tPA within an hour of hospital arrival before and after the initiative was implemented. Results showed that median door-to-needle time for tPA administration decreased from 77 minutes to 67 minutes after Target Stroke was applied. The number of patients who received the treatment within an hour also jumped from just 26.5 percent to 41.3 percent. More importantly, the study showed that the initiative was linked to lower in-hospital all-cause mortality and less frequent incidences of symptomatic intracranial hemorrhage.

Dr. James C. Grotta commented, “[T]he stroke community now has data pointing to how, with some substantial effort and investment, tPA treatment can be administered more quickly.” According to Dr. Grotta, the study provides evidence to guide efforts in improving patient treatment outcomes, specifically through cutting the time from symptom onset to treatment.

The study was published in the April issue of the Journal of the American Medical Association.