Lynchburg Business

Investing in Stroke Prevention

Issue: May 2010 by Lynchburg Business in Healthcare, Inside The Magazine

Stroke strikes nearly 800,000 people annually, killing more than 143,000 and forever changing the lives of many who survive. The third leading cause of death in the United States, stroke is the foremost cause of serious, long-term disability across the country.

Strokes can, and do, hit every age group, with nearly 25 percent of strokes occurring in people under the age of 65, many of whom are still in the workforce. Up to 80 percent of strokes are preventable, according to the National Stroke Association, and business and industry can make a difference in their employees’ lives by implementing strategies to prevent stroke and cardiovascular disease.

A study by researchers at the Centers for Disease Control and Prevention (CDC) concludes that comprehensive worksite health-promotion programs, health plans that cover preventive benefits and effective healthcare systems have the greatest impact on stroke and heart disease and are likely to reduce employers’ health and productivity-related costs. Employers can yield a $3 to $6 return on investment for each dollar invested over a two to five year period in comprehensive worksite health-promotion programs and by choosing health plans that provide adequate coverage and support for essential preventive services, according to the study.

To reduce the high cost associated with long-term disability from stroke, the CDC researchers point to health care settings that use standardized treatment and prevention protocols consistent with national guidelines, multidisciplinary clinical care teams that deliver quality patient care, clinics that specialize in treating/preventing risk factors, physician and patient reminders and electronic medical records.

Centra Lynchburg General Hospital holds The Joint Commission’s national Certificate of Distinction for Primary Stroke Centers, a certification that recognizes centers that make exceptional efforts to foster better outcomes for stroke care. Certification means Centra complies with the highest national standards for safety and quality of care and signifies that the services at Centra have the critical elements to achieve long-term success in improving outcomes for stroke patients. These include organization, correct evaluation and medication, education to reduce the risk of additional strokes and rehabilitation to maximize the patient’s future.

One of the most cost-effective treatments for stroke is a thrombolytic drug called tissue plasminogen activator (t-PA), which helps reestablish blood flow to the brain by dissolving the clots that are blocking the movement of blood. The drug is offered at Centra, and its effectiveness and reduction in costs associated with long-term disability far outweigh the initial expense of t-PA treatment.

To be effective, t-PA must be given quickly—within three hours after the onset of stroke symptoms. People who do not get to the hospital quickly enough lose the window of opportunity for rapid intervention and the best chance to return to a normal, healthy lifestyle. Tests to determine if a patient qualifies for t-PA can take up to an hour, meaning stroke patients should be at the hospital within two hours of the first signs of stroke. The use of t-PA is determined by strict criteria, among which are blood work, a patient’s score on the National Institutes of Health’s stroke scale and the three-hour time limit.

Sixty percent of patients fail to qualify for t-PA simply because they do not reach the hospital in time, primarily because they do not recognize the signs and symptoms of a stroke, suffer a stroke while sleeping or do not feel any pain and decide to wait to see if the symptoms go away. Stroke is an emergency and requires immediate medical attention. Companies can help prevent death and long-term disability by educating employees about the symptoms of stroke and the need to call 9-1-1.

The National Stroke Association’s code stroke program is called FAST, and identifies possible stroke patients, giving all hospital members, from housekeeping staff to nurses, the resources and the responsibility to activate the hospital’s code stroke response team. FAST is an acronym used to pinpoint four key signs of stroke: Facial droop, Arm drift, Speech difficulty and Time. Using state-of-the- art processes and procedures, including CT angiograms, profusion studies and MRI equipment, doctors and nurses at Centra are able to evaluate the seriousness of stroke and determine the appropriate medical care.

If a stroke victim fails to arrive at the hospital in time for thrombolytic treatment, Centra’s specialized nursing and physician care and rehabilitation services also can improve outcomes. Studies show that the main determinant as to how well patients do after suffering a stroke is the focus of the hospital on a stroke victim. Centra’s dedicated neural unit, with its specialized physicians and nurses as well as its rehabilitation services, offers the best opportunity for recovery from stroke.

Centra provides stroke care for more than 700 patients annually. For more information, visit CentraHealth.com.