Reducing the Impact of Stroke in Tennessee

There is a killer at work in Tennessee. In 2010, stroke killed almost 3,000 people in our state … and nationally, the damage is just as alarming.

According to the U.S. Centers for Disease Control (CDC), almost 800,000 people suffer a stroke each year, and more than half of them are women. In fact, stroke is the fourth leading cause of death overall, but the third leading cause of death for women. Despite these numbers, however, many women remain unaware of their risk.  

Consider this: while 425,000 women suffer from stroke each year, a recent study found that less than one in three women could name more than two primary stroke symptoms. To address this lack of knowledge about the impact of stroke on women, the American Heart Association (AHA) and the American Stroke Association (ASA) have recently been promoting guidelines aimed at preventing strokes in women.

If the past 10 years or so is any indication, this initiative should yield results. From 2000 to 2010, education on risk factors, symptoms and the optimal treatment window shined a spotlight on stroke that worked its way into the public consciousness. It’s not surprising then that within that same time period death rates declined — falling more than 35 percent.

But the war on stroke has been waged on other fronts, as well. Since Food & Drug Administration approval of the “clot-busting” tissue plasminogen activator (tPA) in 1996, scientific advancements have introduced neurointerventional techniques and devices that have expanded the treatment window from three hours to eight. Stroke care delivery has improved, with emergency transport guidelines and certifications that define specific personnel, equipment and treatment criteria that hospitals must meet to be deemed a primary or comprehensive stroke center. 

Tennessee has also taken on the challenge and is winning. The Heart Disease and Stroke Prevention Program was started in 2002 with a CDC grant to reduce the burden of heart disease and stroke in Tennessee. Since then, our state has worked to develop and implement the Tennessee Heart Disease and Stroke Prevention and Care Plan, which has successfully rallied partners to advance public education, identify barriers in access to care, and ensure emergency medical service personnel are equipped to appropriately assess patients and immediately transfer them to a hospital with comprehensive or primary stroke center status.

Stroke — perhaps more so than any other disease — requires a coordinated, multi-disciplinary effort to ensure the efficient deployment of appropriate care. We effect successful outcomes by bringing together physicians from many different disciplines, all of whom contribute their expertise to provide appropriate treatment within a narrow time window. 

While the results of our efforts in individual institutions, as well as statewide, are commendable, there is still more work to be done. Neurointervention — its success evident in thousands of lives saved — must continue to be evaluated in clinical trials. Patient registries are critical to ensuring process improvement and better outcomes. And hospitals must embrace coordinated care models that leverage the expertise of specialists from various backgrounds to ensure optimal patient care.

To that end, the Society of NeuroInterventional Surgery was in Nashville recently as part of a national stroke summit tour to advance the dialogue among the “stroke team” professionals involved in the diagnosis, treatment and management of stroke. These summits welcome first responders, emergency room physicians, radiologists, neurologists and neurointerventional surgeons, and others who specialize in stroke treatment to discuss trends, treatment advancements and best practices in stroke care delivery in the hospital setting.

Someone suffers a stroke every 40 seconds in the U.S. — and our wives, mothers, aunts and sisters are bearing the brunt of this deadly disease. But, researchers, physicians, advocates and lawmakers have proven themselves undeterred in the face of this enemy. I am proud of our work in Tennessee to reduce the impact of stroke. Building on our accomplishments, and with this new initiative to promote collaboration and strengthen the stroke team within the hospital environment, the battle is ours to win.