Congratulations to Jason Mackey, MD, and Dawn Kleindorfer, MD, on their authorship of “Stroke Centers and Quality of Stroke Care,” an editorial* in the May edition of the prestigious journal Neurology. Dr. Mackey, a second-year fellow in the Department of Neurology, and Dr. Kleindorfer, Associate Professor of Neurology and Director of the Division of Vascular Neurology, are members of the UC Cerebrovascular Disease and Stroke Center at UCNI and the Greater Cincinnati / Northern Kentucky Stroke Team.

In their editorial, Drs. Mackey and Kleindorfer summarized highlights of a study of outcomes of primary stroke centers certified by the Joint Commission. Data about how patients fare when treated at primary stroke centers had been lacking. (The UC Neuroscience Institute, one of the earliest certified centers, was first certified in 2005 and was re-certified in 2007.)

The study, led by Judith Lichtman, PhD, MPH, of Yale University, compared 30-day mortality and readmission rates of patients in certified hospitals to 30-day rates in uncertified hospitals in 2006. The patients were 65 and over and had suffered an ischemic stroke (a stroke caused by a blockage).

Because the rates were similar – 10.7 percent mortality in certified centers vs. 11.0 percent in uncertified, with similar readmission rates – the study did not evoke a thunderous response. Nevertheless, as the authors pointed out, 49 percent of the certified centers had significantly lower rates than the national average, compared to only 19 percent of non-certified centers.

Meanwhile, viewing the larger picture, Drs. Mackey and Kleindorfer noted that stroke treatment has improved significantly in recent years, with the death rate dropping 34.3 percent from 1997 to 2007. A study recently published by emergency medicine and neurology researchers at UC found that the rate of treatment with the standard therapy for acute ischemic stroke patients has doubled since 2005.

Certified stroke centers, which have been at the forefront of research, public education and physician training, can surely take a bow for these improvements in America’s approach to stroke.

* The pay-for-view editorial can be found at: http://www.neurology.org/content/76/23/1956.full.pdf+html