From the New York Times, 5/28/07: "Lifesaving Opportunities Missed, Before and After Stroke"
"... Although tPA was shown in 1996 to save lives and prevent brain damage, and although the drug could help half of all stroke patients, only 3 percent to 4 percent receive it. Most patients, denying or failing to appreciate their symptoms, wait too long to seek help -- tPA must be given within three hours. And even when patients call 911 promptly, most hospitals, often uncertain about stroke diagnoses, do not provide the drug.
'I label this a national tragedy or a national embarrassment,' said Dr. Mark J. Alberts, a neurology professor at the Feinberg School of Medicine at Northwestern University. 'I know of no disease that is as common or as serious as stroke and where you basically have one therapy and it's only used in 3 to 4 percent of patients.' "
The Joint Commission, which accredits hospitals, has begun also to certify certain hospitals as Primary Stroke Centers. In my metropolitan area, only the two largest, center-city hospitals, 30 minutes away, are certified. Yet I am certain that our local EMS would take me only to the nearest hospital if I were having stroke symptoms, and there is virtually no chance that I would receive tPA -- the difference between recovery and long-term disability.
This seems worthy of a great deal more attention.