UNC joins others to form state's first collaborative stroke registry

“Our chief goal will be to improve the quality of care patients receive when they come into emergency departments after suffering a stroke,” said Dr. Wayne D. Rosamond, associate professor of epidemiology at the UNC School of Public Health.

“Before long, hospitals across the state will be able to access the Web-based registry database and quickly determine how they are doing with stroke care and how they compare with the ideal and with other hospitals across North Carolina in the aggregate.”

Not long after hospitals start feeding information into the system, they can ask — and get answers to — such questions as “In the past week, how many of our patients received a CT brain scan within the first 20 minutes?” Rosamond said. Another example would be “How many of our patients are getting the right kind of screening this month?”

State and UNC public health experts have a strong interest in improving acute stroke care, he said. Stroke is the third leading cause of death nationwide, and North Carolina ranks in the top five states in mortality from that often-catastrophic event. The state is located in a region of the U.S. known as the stroke belt, a group of 11 Southeastern states with a stroke mortality rate significantly above the national average. Moreover, the eastern counties of North Carolina, South Carolina and Georgia comprise the buckle of the stroke belt, an area that has historically had the highest mortality rates in the nation.

“It’s a fact that there’s a significant burden of stroke in North Carolina,” Rosamond said. “Some of our counties, for example, have two to three times the national average in stroke deaths.

“Many factors contribute to North Carolina’s place in the stroke belt and may include elements such as diet, exercise, overall education levels and distances patients live from emergency treatment.”

The CDC selected North Carolina from an applicant pool of 37 states.

“North Carolina’s Acute Stroke Registry is unique in the degree of collaboration that has accompanied the work of applying for funding, first for the prototype phase and, later, for implementation,” said Libby Puckett, director of the Heart Disease and Stroke Prevention Branch of the N.C. Department of Health and Human Services.

The Stroke Registry contract is administered by the N.C. Department of Health and Human Services, which contracted with the university. Registry leaders routinely engage in discourse with representatives from the participating hospitals, and their ideas are incorporated into the program’s design and implementation.

“Collaboration among the state health department, the UNC-Chapel Hill School of Public Health and North Carolina hospitals of varying sizes and types helped us become one of only four states in the country to be funded for this work,” Puckett said.

Massachusetts, Georgia and Illinois also received federal funding, she said.

Jeff Williams, chief executive officer of Clinipace, called the stroke work important and said it was an example of how software the company developed, patented and named “Tempo” can facilitate collaborative clinical research between distant locations.

While the registry aims to help hospitals improve treatment efficiency, Rosamond said it’s important for people to recognize stroke symptoms and quickly seek medical attention. People who think they or someone else is suffering a stroke need to call 911 to summon emergency medical service immediately. Some stroke treatments, such as a clot-dissolving drug known as tPA, need to be given within three hours of symptom onset, he said.

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Note: Rosamond can be reached at (919) 843-2396 or wayne_rosamond@unc.edu.

News Services contact: Lisa Katz, (919) 962-2093

For further information please contact Ramona DuBose by email at ramona_dubose@unc.edu