Stroke Research Today is a free monthly online journal that collates and summarizes the latest research about Stroke, including details on treatment, recovery, rehabilitation, signs, symptoms.

Stroke units, tissue plasminogen activator, aspirin and neuroprotection: which stroke intervention could provide the greatest community benefit?

Gilligan AK, Thrift AG, Sturm JW, Dewey HM, Macdonell RA, Donnan GA

Department of Neurology, Austin and Repatriation Medical Center, Heidelberg, Australia.

BACKGROUND: Although a number of acute stroke interventions are of proven efficacy, there is uncertainty about their community benefits. We aimed to assess this within a defined population. METHODS: Eligibility for tissue plasminogen activator (tPA), aspirin, stroke unit management and neuroprotection were assessed among incident stroke cases within the community-based North East Melbourne Stroke Incidence Study. RESULTS: Among 306,631 people, there were 645 incident strokes managed in hospital. When eligible patients were extrapolated to the Australian population, for every 1,000 cases, 46 (95% CI 17-69) could have been saved from death or dependency with stroke unit management, 6 (95% CI 1-11) by using aspirin, 11 (95% CI 5-17) or 10 (95% CI 3-16) by using tPA at 3 and 6 h, respectively. CONCLUSIONS: Although tPA is the most potent intervention, management in stroke units has the greatest population benefit and should be a priority.

Published 19 September 2005 in Cerebrovasc Dis, 20(4): 239-44.
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