Study Says Stroke Treatment Varies


Wednesday, February 14th 2001, 12:00 am
By: News On 6


FORT LAUDERDALE, Fla. (AP) — People who live in the Midwest are five times as likely as Southerners to receive brain-saving clot-dissolving drugs when they have strokes, a study found.

The study shows striking differences between regions and races in the way doctors administer TPA, the only drug that can stop a stroke in its tracks.

``There is a big disparity in the way TPA is being administered in the United States, even in big academic medical centers that are considered to be the elite,'' said Dr. David Tong of Stanford University.

Tong's findings were based on an analysis of 42 medical school-affiliated hospitals across the country. Each provided data on 30 consecutive stroke patients. He presented the data Wednesday at a meeting in Fort Lauderdale of the American Stroke Association.

Across the country, about 6 percent of stroke patients are given TPA at these big medical centers. The figure is probably lower at smaller hospitals.

The figure is low for a variety of reasons, but doctors say the most important is that only about one-third of patients get to the hospital within three hours of the start of their symptoms. The drug cannot be used later than that.

Tong found that at the hospitals surveyed, TPA was given to 5 percent of stroke victims in the Northeast, 4 percent in the West, 2 percent in the South and 11 percent in the Midwest.

Racial differences were also great. Fourteen percent of whites got TPA, as did 7 percent of Hispanics and 1 percent of blacks. No Asians received TPA.

Tong said there is no clear explanation for either the regional or the racial differences. He speculated that some people, such as Asians, may be especially reluctant to seek medical care until it is too late for TPA.

Dr. Sidney Smith Jr., chief science officer of the American Heart Association, said other studies have also shown that doctors in the South are less likely than usual to prescribe recommended beta blocker drugs for people who have survived heart attacks.

``There may be some differences in continuing medical education for physicians and how the word about TPA has gotten out,'' he said.

Tong said that about 30 percent of stroke patients get to hospitals within three hours of their heart attacks. However, about half of these patients cannot have TPA because of other medical conditions that increase their risk of dangerous bleeding in the brain.