Stroke System Overview

Stroke is the fourth leading cause of death in the United States. Over 143,579 people die each year from stroke in the United States and stroke is the leading cause of serious, long-term disability in the United States. Nearly three-quarters of all strokes occur in people over the age of 65. The risk of having a stroke more than doubles each decade after the age of 55. However, in the southeastern United States the occurrence of stroke at significantly younger ages is not unusual. Stroke killed 2,538 Alabamians in 2011, and on average, someone dies of stroke in the United States every four minutes.

Stroke has a major impact on a person's life and can lead to long-term disability necessitating long-term care. The wide range of disabilities faced by stroke survivors predisposes them to variable dependence on their caregivers in order to lead a more normal life-leading to stroke being considered a family illness. Services for stroke, however, fail to recognize the need of caregivers and this may lead to significant deterioration in caregivers' health and quality of life. The sudden loss of ability following stroke stresses the family of stroke survivors.

Of all strokes, 87 percent are ischemic, ten percent are intracerebral hemorrhage, and three percent are subarachnoid hemorrhage. In 1995, tissue plasminogen activator (tPA, Activase®) became the first and only approved treatment for acute ischemic stroke (AIS). Because tPA has to be administered within the first few hours of AIS onset, delivering this treatment to patients who qualify within the established time limits is challenging. To overcome this problem, development of a statewide plan to route these stroke patients to the closest facility that can make this treatment available to eligible patient as rapidly as possible is of paramount importance. While thrombolytic therapy of ischemic stroke with tPA has been the impetus for care changes, it was recognized from the outset that the successful treatment of any type of stroke will require rapid response to all stroke types.

The primary goal of the Alabama Statewide Stroke System is to develop a stroke emergency care system that will result in 100 percent tPA administration to all eligible patients and a minimum of ten percent administration to all ischemic stroke patients, as well as decreased stroke mortality and disability in the State of Alabama.

For more information on stroke in Alabama, view The Risk of Heart Disease and Stroke in Alabama: Burden Document.