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North Carolina Stroke Prevention and
Treatment Facilities Survey
rtPA Therapy for Acute Stroke
Larry B. Goldstein, MD; Lloyd A. Hey, MD; Ronnie Laney, BS
Background and Purpose—North Carolina is situated in the “stroke belt” region of the United States, an area of the
country with a particularly high incidence of cerebrovascular disease. The North Carolina Stroke Prevention and
Treatment Facilities Survey was carried out to determine the availabilities of a variety of stroke prevention and treatment
services throughout the state. The purpose of the present study was to determine how widely recombinant tissue-type
plasminogen activator (rtPA) has been adopted for the treatment of patients with acute ischemic stroke and to determine
the characteristics of the medical facilities in the state offering this therapy.
Methods—A singlesurvey was mailed to the medical center directors of each inpatient medical facility in North
Carolina. Data collected included questions related to the availability of selected basic and advanced diagnostic tests and
procedures, stroke prevention and treatment programs and services (community stroke awareness program, acute stroke
identification program, acute stroke team, stroke rtPA protocol, stroke care map, neurologist), and facilities (Stroke
Acute Care Unit or equivalent).
Results—Responses were obtained from all 125 inpatient medical facilities in North Carolina. rtPA stroke protocols were
adopted in 54 facilities located in 46 of the state’s 100 counties. Seventy-four percent of the state’s population resides
in counties with hospitals providing rtPA treatment. Compared with facilities not offering rtPA, those with rtPA
protocols more commonly sponsored stroke community awar
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