More than one in 10 Utah stroke patients die in Utah hospitals, according to new data released Wednesday.

It's the highest death rate of any type of hospital deaths that the state tracks, including heart attacks, heart failure and pneumonia. The problem is timing: For the most common type of stroke, patients have just three hours to receive a powerful clot-busting drug to reduce the chances of permanent disability. But some patients take too long to get to the hospital, and some hospitals take too long to diagnose and treat stroke patients.

The Utah Department of Health is developing a stroke network, in which hospitals would agree to follow nationally accepted standards of care so they don't have to spend time determining what to do. They would have a "stroke box" at the ready, stocked with equipment and drugs, to treat patients more quickly.

"You are seeing at all smaller hospitals a lot of wasted time in the diagnosis of the stroke and the decision to treat or not treat," said Peter Taillac, medical director of the Health Department's Bureau of Emergency Services and an ER doctor at the University of Utah.

In these lean times, Taillac is hoping legislators will pay for the $100,000 annual administrative cost for the stroke system and another for a type of deadly heart attack by tapping a proposed $2.30 increase in the cigarette tax. He said the two systems will save "millions" a year. "A tobacco tax would be a natural way to fund such a program for two diseases that are directly caused by cigarette smoking."

The Health Department released its annual hospital comparison reports Wednesday, looking at how patients fare for a variety of conditions at Utah hospitals.

The reports show most Utah hospitals do a better or similar job than their national counterparts treating heart conditions. However, two hospitals did worse: Salt Lake Regional had more deaths than expected for heart bypass patients, at 6.9 percent; and Davis Hospital for heart failure patients, at 7.8 percent. Officials for both hospitals disputed the report. The CEO of Salt Lake Regional said the bypass death rate didn't account for the sickness of the patients.

The Health Department said it does take severity of illness into account, while acknowledging it may not capture the "full complexity" of the cases.

The CEO of Davis noted that a "high percentage" of patients with heart failure were admitted with "do not resuscitate" orders.

From 2005 to 2007, 10.5 percent of stroke patients died, on par with similarly sick patients nationwide. Two hospitals had fewer deaths than expected: LDS and St. Mark's in Salt Lake City. But one, Uinta Basin in Roosevelt, had more deaths. However most of that hospital's deaths were of patients who were there to die, according to the hospital.

Utah has four certified stroke centers -- Intermountain Medical Center in Murray, McKay Dee in Ogden, University of Utah in Salt Lake City and Utah Valley Regional in Provo. They have staff on hand 24-7 for rapid response. Staff at rural hospitals typically consult with the larger ones over the phone. But Taillac said more doctors and nurses throughout Utah need to be trained.

"We would much prefer to elevate the level of care at every hospital so that an uncomplicated stroke patient can get the same level of care anywhere."

Starting this summer, hospitals will be invited to apply to become a stroke-receiving facility. The designation will require education on using a drug called tissue plasminogen activator, which has proven to be effective treating the type of strokes caused by blood clots that block blood flow to the brain. The hospitals must also have a CT scan available at all hours, among other requirements. Emergency dispatchers would be trained to recognize stroke symptoms and prioritize those calls.

Taillac said a similar system is being developed to quickly diagnose and treat a heart attack known as a STEMI, which brings a high risk of death. Patients need an angioplasty -- in which a balloon is inserted in the collapsed coronary artery and inflated to restore blood flow -- within 90 minutes of admission. Or they need a clot-busting drug within a half hour, which is less effective.

The reports comparing hospitals are available online at http://health.utah.gov/myhealthcare.

hmay@sltrib.com