A disturbing report out of the American Heart Association says that the vast majority of stroke patients are not getting the best possible care during, and after hospitalization.
Stroke is the third leading cause of death and the leading cause of disability.
The problem really lies first in the fact that people just don’t know enough about stroke to recognize the signs of stroke. Even once they are in the emergency room, the study shows that doctors are not giving patients what they need.

Dominick Protomastro is one of the few stroke patients who got the correct care, thanks to his wife. “I couldn’t get up off the floor. My wife called 911 and I made it to the hospital.”
He survived thanks to his doctors. “I had every test known to man. I had carotid ultrasounds, I had EKG’s, I had CT scans, MRIs and all kinds of blood work done,” says Dominick.
The fact is, few acute stroke patients like Dominic receive care consistent with established stroke guidelines. According to a report in the latest issue of Stroke, a journal of the American Heart Association, the problem begins with patients simply not getting to the hospital quickly enough. The study was funded by the U.S. Centers for Disease Control and Prevention.
When you have a stroke, the clock is not on your side. You have three hours to get to the emergency room to get the clot busting medicine called TPA. Unfortunately, fewer than 5% of patients eligible for TPA receive it.
Understand that most strokes—90 percent of them—are caused by a blockage in one or more of the arteries feeding the brain. This is called an ischemic stroke--ischemic meaning starving of blood flow and oxygen. That blockage needs to be reopened before the part of the brain fed by the artery permanently dies.
Dr. Keith Siller, a neurologist at NYU Medical Center, says, “The biggest problem with stroke patients right now and historically, is that even people who have had a stroke who are medically savvy aren’t aware of what a stroke really is.”
The study also showed many stroke patients do not receive recommended preventive care before leaving the hospital—things like cholesterol measurement—only around 35% got that. Other measures that can help stroke patients is to take an aspirin to thin the blood, and perhaps the most useful, quitting smoking.
The research also found that only about half the patients were screened for swallowing difficulty, which should be routine. The problem can result in aspiration pneumonia if food is swallowed into the lungs.
“As far as follow up is concerned, every patient who has had a stroke is at risk for another one. It’s not enough to come in at the final hour and give the patient TPA. That’s just the tip of the iceberg,” says Dr. Siller.
It’s a lesson that both patients and doctors need to pay closer attention to this leading cause of death and disability in America.
For more information on strokes, go to:
HTTP://WWW.STROKEASSOCIATION.ORG

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