Regional Intervention of Stroke Care to Increase Thrombolytic Therapy for Acute Ischemic Stroke

Stroke. 2018 Aug;49(8):2008-2010. doi: 10.1161/STROKEAHA.118.021109.


Background and Purpose- The aims of this study were to investigate the effect of an intervention to unblind data on r-tPA (recombinant tissue-type plasminogen activator) administration and sharing data with chief executive officers of participating hospitals, on r-tPA administration rates postintervention and on potential healthcare cost savings implemented at 26 Southeast Texas Regional Advisory Council hospitals. Methods- Retrospective analysis of prospective data on thrombolytic therapy from 26 Southeast Texas Regional Advisory Council hospitals, collected between April 2014 and June 2016. The control (blinded) period (Q2-2014 to Q2-2015) was followed by unblinding (Q3-2015). Results- Intervention was associated with 21.1% increase in r-tPA administration rates, with 38.5% increase in r-tPA administration with door-to-needle time ≤60 minutes. An absolute increase in r-tPA administration of 2.1% was seen with an average lifetime cost savings of $3.6 million. Conclusions- Transparent regional data sharing was associated with improved r-tPA administration and healthcare cost savings.

Keywords: cost savings; hospitals; prospective studies; retrospective studies; stroke, acute; thrombolytic therapy.

MeSH terms

  • Aged
  • Brain Ischemia / drug therapy*
  • Brain Ischemia / economics
  • Brain Ischemia / epidemiology
  • Cost Savings / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Retrospective Studies
  • Single-Blind Method
  • Stroke / drug therapy*
  • Stroke / economics
  • Stroke / epidemiology
  • Texas / epidemiology
  • Thrombolytic Therapy / economics
  • Thrombolytic Therapy / methods*
  • Thrombolytic Therapy / standards*
  • Time-to-Treatment / economics
  • Time-to-Treatment / standards*
  • Tissue Plasminogen Activator / administration & dosage*
  • Tissue Plasminogen Activator / economics


  • Tissue Plasminogen Activator