• Susan Unipan Lattimore, Julio Chalela, Lisa Davis, Thomas DeGraba, Mustapha Ezzeddine, Joseph Haymore, Paul Nyquist, Alison E Baird, John Hallenbeck, Steven Warach, and NINDS Suburban Hospital Stroke Center.
• Stroke Branch, National Institute of Neurological Disorders and Stroke, 10 Center Dr, MSC 1063, Building 10, Room B1D733, Bethesda, Md 20892-1063, USA.
• Stroke. 2003 Jun 1;34(6):e55-7.

Background And PurposeTo increase the proportion of ischemic stroke patients treated with thrombolytic therapy, the establishment of primary stroke centers in community hospitals has been advocated. We evaluated the use of thrombolytic therapy before and after institution of a primary stroke center in a community hospital.MethodsThe availability of an on-call stroke emergency response team was the only significant additional resource required for this hospital. All eligible patients were treated with intravenous tissue plasminogen activator (tPA). The number of patients with cerebrovascular disease, number and proportion of patients treated with tPA, times to treatment, and patient outcomes were recorded during the first 2 years of the stroke center.ResultsDuring the 12 months before institution of the stroke center, 3 ischemic stroke patients (1.5%) were treated with tPA. During the 2-year period of around-the-clock coverage, 44 of 420 ischemic stroke patients (10.5%) were treated with intravenous tPA, a significant increase in tPA use (P<0.0001).ConclusionsEstablishment of a primary stroke center at a community hospital resulted in a substantial increase in the proportion of patients receiving thrombolytic therapy for ischemic stroke. If this experience is generalized, the beneficial impact of primary stroke centers on stroke outcomes and costs to the healthcare system may be substantial.

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