Recommendations for comprehensive stroke centers: A consensus statement from the brain attack coalition

Mark J. Alberts, Richard E. Latchaw, Warren R. Selman, Timothy Shephard, Mark N. Hadley, Lawrence M. Brass, Walter Koroshetz, John R. Marler, John Booss, Richard D. Zorowitz, Janet B. Croft, Ellen Magnis, Diane Mulligan, Andrew Jagoda, Robert O'Connor, C. Michael Cawley, J. J. Connors, Jean A. Rose-DeRenzy, Marian Emr, Margo WarrenMichael D. Walker

Research output: Contribution to journalArticle

Abstract

Background and Purpose - To develop recommendations for the establishment of comprehensive stroke centers capable of delivering the full spectrum of care to seriously ill patients with stroke and cerebrovascular disease. Recommendations were developed by members of the Brain Attack Coalition (BAC), which is a multidisciplinary group of members from major professional organizations involved with the care of patients with stroke and cerebrovascular disease. Summary of Review - A comprehensive literature search was conducted from 1966 through December 2004 using Medline and Pub Med. Articles with information about clinical trials, meta-analyses, care guidelines, scientific guidelines, and other relevant clinical and research reports were examined and graded using established evidence-based medicine approaches for therapeutic and diagnostic modalities. Evidence was also obtained from a questionnaire survey sent to leaders in cerebrovascular disease. Members of BAC reviewed literature related to their field and graded the scientific evidence on the various diagnostic and treatment modalities for stroke. Input was obtained from the organizations represented by BAC. BAC met on several occasions to review each specific recommendation and reach a consensus about its importance in light of other medical, logistical, and financial factors. Conclusions - There are a number of key areas supported by evidence-based medicine that are important for a comprehensive stroke center and its ability to deliver the wide variety of specialized care needed by patients with serious cerebrovascular disease. These areas include: (1) health care personnel with specific expertise in a number of disciplines, including neurosurgery and vascular neurology; (2) advanced neuroimaging capabilities such as MRI and various types of cerebral angiography; (3) surgical and endovascular techniques, including clipping and coiling of intracranial aneurysms, carotid endarterectomy, and intra-arterial thrombolytic therapy; and (4) other specific infrastructure and programmatic elements such as an intensive care unit and a stroke registry. Integration of these elements into a coordinated hospital-based program or system is likely to improve outcomes of patients with strokes and complex cerebrovascular disease who require the services of a comprehensive stroke center.

Original languageEnglish (US)
Pages (from-to)1597-1616
Number of pages20
JournalStroke
Volume36
Issue number7
DOIs
StatePublished - Jul 2005
Externally publishedYes

Fingerprint

Cerebrovascular Disorders
Stroke
Brain
Evidence-Based Medicine
Patient Care
Guidelines
Endovascular Procedures
Cerebral Angiography
Carotid Endarterectomy
Thrombolytic Therapy
Neurosurgery
Intracranial Aneurysm
Neurology
Neuroimaging
Health Personnel
Blood Vessels
Intensive Care Units
Registries
Meta-Analysis
Clinical Trials

Keywords

  • Cerebral hemorrhage
  • Cerebrovascular disorders
  • Healthcare systems
  • Patient care
  • University Medical Centers

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Alberts, M. J., Latchaw, R. E., Selman, W. R., Shephard, T., Hadley, M. N., Brass, L. M., ... Walker, M. D. (2005). Recommendations for comprehensive stroke centers: A consensus statement from the brain attack coalition. Stroke, 36(7), 1597-1616. https://doi.org/10.1161/01.STR.0000170622.07210.b4

Recommendations for comprehensive stroke centers : A consensus statement from the brain attack coalition. / Alberts, Mark J.; Latchaw, Richard E.; Selman, Warren R.; Shephard, Timothy; Hadley, Mark N.; Brass, Lawrence M.; Koroshetz, Walter; Marler, John R.; Booss, John; Zorowitz, Richard D.; Croft, Janet B.; Magnis, Ellen; Mulligan, Diane; Jagoda, Andrew; O'Connor, Robert; Cawley, C. Michael; Connors, J. J.; Rose-DeRenzy, Jean A.; Emr, Marian; Warren, Margo; Walker, Michael D.

In: Stroke, Vol. 36, No. 7, 07.2005, p. 1597-1616.

Research output: Contribution to journalArticle

Alberts, MJ, Latchaw, RE, Selman, WR, Shephard, T, Hadley, MN, Brass, LM, Koroshetz, W, Marler, JR, Booss, J, Zorowitz, RD, Croft, JB, Magnis, E, Mulligan, D, Jagoda, A, O'Connor, R, Cawley, CM, Connors, JJ, Rose-DeRenzy, JA, Emr, M, Warren, M & Walker, MD 2005, 'Recommendations for comprehensive stroke centers: A consensus statement from the brain attack coalition', Stroke, vol. 36, no. 7, pp. 1597-1616. https://doi.org/10.1161/01.STR.0000170622.07210.b4
Alberts, Mark J. ; Latchaw, Richard E. ; Selman, Warren R. ; Shephard, Timothy ; Hadley, Mark N. ; Brass, Lawrence M. ; Koroshetz, Walter ; Marler, John R. ; Booss, John ; Zorowitz, Richard D. ; Croft, Janet B. ; Magnis, Ellen ; Mulligan, Diane ; Jagoda, Andrew ; O'Connor, Robert ; Cawley, C. Michael ; Connors, J. J. ; Rose-DeRenzy, Jean A. ; Emr, Marian ; Warren, Margo ; Walker, Michael D. / Recommendations for comprehensive stroke centers : A consensus statement from the brain attack coalition. In: Stroke. 2005 ; Vol. 36, No. 7. pp. 1597-1616.
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