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October 4, 2000

Issues in Establishing Primary Stroke Centers

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(13):1647. doi:10.1001/jama.284.13.1647

To the Editor: Dr Alberts and colleagues1 reported that primary stroke centers should include "acute stroke teams, stroke units, written care protocols, and an integrated emergency response system." Regrettably, the authors only briefly mentioned the need for rehabilitation to "hasten recovery following stroke." They reported that only 2% to 3% of patients with stroke receive tissue-type plasminogen activator (tPA) nationwide, but they failed to mention that 31% of patients with stroke require assistance in activities of daily living, 20% require assistance in mobility, and 16% are institutionalized.2