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Stroke care has become progressively more complicated with advances in therapies necessitating timely intervention. There are multiple potential providers of stroke care, which traditionally has been the province of general neurologists and primary care physicians. These new players, be they vascular neurologists, neurohospitalists, internal medicine hospitalists, or neurocritical care physicians, at the bedside or at a distance, are poised to make a significant impact on our care of stroke patients. The collaborative model of care may be or become the most prevalent as physicians apply their distinct skill sets to the complex care of inpatients with cerebrovascular disease.
Approximately 795,000 strokes occur each year in the United States, along with 200,000 to 500,000 transient ischemic attacks. Stroke continues to rank third among all causes of death nationally, and approximately 47% of those deaths occur in the hospital. It is estimated that 6.5% to 15% of stroke patients experience their stroke while in the hospital . In 2006, 889,000 patients were discharged from short-stay hospitals with the primary diagnosis of stroke. Stroke remains a leading cause of long-term disability, with an estimated direct and indirect cost in 2010 of $73.7 billion [2•].
Many physicians have felt we have little to offer patients with ischemic stroke; however, dramatic advances in the diagnosis and treatment of these patients have rendered that attitude progressively baseless. With the advent of a new group of physicians dedicated to inpatient care—hospitalists—it is imperative that these specialists, as well as other dedicated inpatient physicians, learn to manage stroke patients and develop systems to optimize stroke care.
Dr. Amin has received research support from and has been a speaker for Sanofi-Aventis.
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