North Carolina’s Stroke Advisory Council has published the results of its survey to gain understanding of the scope of stroke services provided by all North Carolina hospitals. An article on the results has been published in the Journal of Stroke and Cerebrovascular Diseases – Statewide Availability of Acute Stroke Treatment, Services, and Programs: A Survey of North Carolina Hospitals.
In addition to assessing stroke treatment in the state’s hospitals, the Council also examined differences in stroke care capabilities between urban, suburban, and rural hospitals and trends over the past 2 decades. The survey was conducted over the October 2020-April 2021 period and results were compared to survey results in 1998, 2003 and 2008.
The survey had a 100% response rate from all 111 hospitals contacted. Notable results include:
- Among 108 hospitals providing acute stroke care, 12 (11%) were Comprehensive Stroke Centers or Thrombectomy-Capable Stroke Centers
- All Comprehensive Stroke Centers or Thrombectomy-Capable Stroke Centers responding were located in urban or suburban areas
- 38% of urban/suburban hospitals were non-certified
- 48% of rural hospitals were non-certified
- Non-contrast computed tomography (CT), CT angiography, and alteplase treatment were widely available (100%, 95%, and 99%, respectively)
- Endovascular thrombectomy was solely available in urban/suburban hospitals (29%)
- Of non-tertiary hospitals, 81% were using telestroke for treatment and transfer decisions
- Compared to prior survey results, the availability of CT angiography (76% in 2008 to 95% in 2020-2021), alteplase treatment (69% in 2008 to 99% in 2020-2021), and acute stroke clinical pathways (47% in 2008 to 90% in 2020-2021) increased
- Having an in-house neurologist on staff dropped from approximately 55% in prior surveys to 21%
The study concludes that rural North Carolina hospitals are less likely to have advanced diagnostic imaging and treatment capabilities for acute stroke, and identifies the need for in-house neurologists and use of telestroke services need to be points of emphasis going forward.