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Study Gives 'Striking' Snapshot of Stroke Prognosis

Two-Thirds of Medicare Patients Face Death, Hospital Readmission in Year After Stroke

Second Opinion

Patrick Lyden, MD, chairman of the department of neurology at Cedars-Sinai Medical Center in Los Angeles, says the findings likely apply to all senior citizens with stroke -- not just Medicare beneficiaries.

“It is very generalizable because most strokes occur in the Medicare-eligible population,” he says.

“Stroke patients are much more concerned about stroke-related disability,” he says. “What matters is are we making patients better. We need to be focusing on stroke-related disability and getting people treated in primary stroke centers.”

A clot-busting agent should be given as soon as possible after an ischemic stroke to reduce long-term damage, and this is more likely to be administered at a stroke center, he says.

Stroke warning signs include sudden numbness or weakness in the face, arm, or leg; sudden confusion, trouble speaking, sudden trouble walking, and/or a severe headache that comes on suddenly.

“Call 911 if you suspect a stroke,” Lyden says. “It is becoming more and more common for medics to direct people to stroke centers,” he says.

Aggressive Follow-up Care Can Lower Death, Readmission Rates After Stroke

Stroke is a slippery slope, says Irene Katzan, MD a stroke neurologist in the Neurological Institute at Cleveland Clinic and the director of Enterprise Stroke Systems in the Center for Outcomes Research and Evaluation in Ohio.

“Stroke is a bad disease and occurs in patients who are often sick and have other comorbid diseases,” she says. People who have strokes are often left severely disabled, and when you are disabled, you are prone to readmission and death, she says.

“This paper provides an overall national picture of how bad the problem is, and this is the tip of the iceberg because most people don’t die from a stroke, but are left functionally disabled,” she says. “These findings are not surprising, but it is sobering to see it in print on a national scale,” Katzan tells WebMD.

But aggressive follow-up care can help make a dent in these sobering statistics, she says.

“Once you leave the hospital, you should follow up with a neurologist or primary care physician so they reduce the chance of death or readmitted,” she says.

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