Newswise — New Brunswick, NJ – New research published today in the Journal of the American Heart Association indicates that patients who are treated for hemorrhagic stroke at a comprehensive stroke center are more likely to receive specialized treatment, reducing the risk of mortality. Physicians at the Cardiovascular Institute of New Jersey at Rutgers Robert Wood Johnson Medical School and the Comprehensive Stroke Center at Robert Wood Johnson University hospital conducted the study utilizing the Myocardial Infarction Database Acquisition System (MIDAS) to determine that patients admitted to comprehensive stroke centers, as well as patients transferred to comprehensive stroke centers within 24 hours of initial hospitalization, were more likely to survive.
Stroke is a leading cause of death and disability in the United States according to the American Heart Association and American Stroke Association Previous research has shown that comprehensive stroke centers improve clinical outcomes and reduce disparities in ischemic stroke, which is caused by a blockage in blood vessels. The new research reveals that the same may be true for patients who experience hemorrhagic stroke, when there is bleeding in or around the brain, which has a mortality rate of 40 to 50 percent.
“Hemorrhagic stroke is complex and requires skilled medical interventions to improve a patient’s outcome,” said James S. McKinney, MD, assistant professor of neurology at Rutgers Robert Wood Johnson Medical School and medical director of the Comprehensive Stroke Center at Robert Wood Johnson University Hospital and lead author of the study. “Our research indicates that the use of neurosurgical and endovascular treatments that are available at state-designated comprehensive stroke centers are associated with lower mortality in patients with hemorrhagic stroke.”
Studying demographic and clinical data available through MIDAS, a state-wide database of hospitalizations for myocardial infarction (heart attacks), stroke, other vascular diseases, and deaths from 1990 to the present, the researchers reviewed more than 36,000 anonymous patient records from 1996 to 2012. The review included admissions and discharge data for 87 non-federal New Jersey hospitals, each designated as a comprehensive stroke center, primary stroke center or nonstroke center, by the New Jersey Department of Health and Human Services. In New Jersey, comprehensive stroke centers must be staffed 24-hours-a-day, seven-days-a-week, with a neurosurgical team including diagnostic and interventional neuroradiologists.
Despite the availability of 13 designated comprehensive stroke centers in New Jersey, the study noted that only 40 percent of patients were admitted to a comprehensive stroke center during the study time period from 1996 to 2012, while the remaining 60 percent were admitted to either a primary stroke center or nonstroke center.
“Based on the evidence presented in our study, we believe that more patients can survive hemorrhagic stroke with better utilization of the state’s comprehensive stroke centers,” said Dr. McKinney.
According to Dr. McKinney, variables other than comprehensive treatment contributed to improved outcomes, including age.
“In our analysis, patients admitted to comprehensive stroke centers were, on average, five years younger than patients admitted to other hospitals,” said Dr. McKinney. “In addition, patients transferred to comprehensive stroke centers were significantly younger in age than patients who remained in primary stroke or nonstroke centers.”
The research team, all members of the Cardiovascular Institute of New Jersey, included Jerry Q. Cheng, PhD, assistant professor of medicine; Igor Rybinnik, MD, assistant professor of neurology; and John B. Kostis, MD, John G. Detwiler Professor of Cardiology, associate dean for Cardiovascular Research and director, Cardiovascular Institute of New Jersey.
The study was funded, in part, by the Robert Wood Johnson Foundation.
About Rutgers Robert Wood Johnson Medical SchoolAs one of the nation's leading comprehensive medical schools, Robert Wood Johnson Medical School is dedicated to the pursuit of excellence in education, research, health care delivery, and the promotion of community health. Robert Wood Johnson Medical School and Robert Wood Johnson University Hospital, the medical school's principal affiliate, comprise one of the nation's premier academic medical centers. In addition, Robert Wood Johnson Medical School has 34 other hospital affiliates and ambulatory care sites throughout the region.
Part of Rutgers, The State University of New Jersey, Robert Wood Johnson Medical School encompasses 20 basic science and clinical departments, hosts centers and institutes including The Cardiovascular Institute, the Child Health Institute of New Jersey, the Center for Advanced Biotechnology and Medicine, the Environmental and Occupational Health Sciences Institute, and the Stem Cell Institute of New Jersey. The medical school maintains educational programs at the undergraduate, graduate and postgraduate levels on its campuses in New Brunswick and Piscataway and provides continuing education courses for health care professionals and community education programs. To learn more about Rutgers Robert Wood Johnson Medical School, visit rwjms.rutgers.edu. Find us online at www.facebook.com/RWJMedicalSchool and www.twitter.com/RWJMS.
Journal Link: Journal of the American Heart Association, May 2015
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