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Remember unique needs of elder stroke patients
Older ED stroke patients are at substantially higher risk for adverse clinical outcomes, including in-hospital mortality, warns Gregg C. Fonarow, MD, director of the Ahmanson University of California-Los Angeles Cardiomyopathy Center.
"It is very important that these patients receive timely assessment and optimal care from the time of presentation to the ED, throughout hospitalization, and in transition to outpatient care," says Fonarow. "Ensuring evidence-based therapies are provided in a timely fashion is critical."
In a recent study, researchers analyzed outcomes in 502,036 ischemic stroke admissions from 1,256 hospitals in the Get With the Guidelines Stroke program from 2003 to 2009.1 They found some good news: Age-related treatment gaps were narrowed or eliminated over time for most ischemic stroke performance measures.
"I was surprised by how much care for older ischemic stroke patients had improved," says Fonarow, the study's lead author.
Assessing and managing older patients with ischemic stroke can be particularly challenging, though, as these patients have more comorbid conditions, says Fonarow. "The burden of stroke is borne disproportionately by older patients, who have a greater incidence, mortality, and prevalence of ischemic stroke than younger individuals," he says. "Achieving door to CT times within 25 minutes and door-to-needle times with IV tPA within 60 minutes remain areas that are challenging for ischemic stroke patients of all ages."