Trends in treatment and outcomes for acute stroke patients in Ontario, 1992-1998.

Abstract

STROKE IS the leading cause of long-term disability in adults and the third most common cause of death in North America.^1,2 The 1980s and 1990s have witnessed the development of several interventions that improve the short- and long-term outcomes of patients with stroke (hereafter referred to as stroke patients). Interventions that improve the outcomes in acute stroke include thrombolytic therapy for patients presenting with an ischemic stroke within 3 hours of stroke onset and aspirin administration within 24 hours of admission.^3,4 Admission to a stroke unit has also been associated with better outcomes.⁵ A number of therapies have been developed that reduce the risk for recurrent strokes. These include aspirin, ticlopidine hydrochloride, clopidogrel bisulfate, statins, and warfarin sodium (Coumadin).^6-10 In addition, carotid endarterectomy has been shown to be effective in preventing strokes in patients with high-grade carotid stenosis.¹¹