Introduction
Stroke patients who are treated quickly have better outcomes than those who arrive at the hospital after a delay. The National Stroke Association recommends that hospitals be capable of treating stroke within three hours of symptom onset. “Time lost is brain lost,” says Dr. Ralph Sacco, a neurologist and president of the American Heart Association and American Stroke Association. “The faster you can get to the hospital, the better chance you have at saving your brain.”
The National Stroke Association recommends that hospitals be capable of treating stroke within three hours of symptom onset.
What is a stroke?
A stroke occurs when blood flow to the brain is interrupted, leading to damage. This can be caused by a blood clot or bleeding in the brain. The symptoms of a stroke are often sudden and include:
- Numbness or weakness on one side of your body
- Confusion, difficulty speaking or understanding what others are saying
- Difficulty walking, dizziness, loss of balance or coordination
- Severe headache with no known cause
“Time lost is brain lost,” says Dr. Ralph Sacco, a neurologist and president of the American Heart Association and American Stroke Association. “The faster you can get to the hospital, the better chance you have at saving your brain.”
Time lost is brain lost.
The faster you can get to the hospital, the better chance you have at saving your brain.
Time to treatment is critical for stroke survival, but it’s also a function of distance and time. In other words, if it takes more than an hour for you or your loved one to reach a hospital after experiencing any type of warning sign for stroke (like sudden weakness on one side of the body), then it may be too late by the time they arrive at the hospital and receive medical attention.
In the new study, researchers analyzed data from 1,478 Medicare patients who suffered an attack in one of 1,676 hospitals across the United States between 2009 and 2014. The analysis found that only 25 percent of those patients received emergency care within three hours.
In the new study, researchers analyzed data from 1,478 Medicare patients who suffered an attack in one of 1,676 hospitals across the United States between 2009 and 2014. The analysis found that only 25 percent of those patients received emergency care within three hours.
“It’s not acceptable when you look at other countries where stroke is a leading cause of death,” says Dr. Jeffrey Saver, professor of neurology at UCLA School of Medicine and senior author on the study. “We’re behind our international peers in getting people to these specialized centers.”
The researchers then identified more than 100 factors that could have contributed to delays in treatment for each patient and assigned a numerical value to each factor. They applied these values to data from 612 patients treated at Scripps Mercy Hospital in San Diego. They found that delays were most often caused by problems with emergency services or transportation and insurance or registration issues — all factors outside of a hospital’s control.
The researchers then identified more than 100 factors that could have contributed to delays in treatment for each patient and assigned a numerical value to each factor. They applied these values to data from 612 patients treated at Scripps Mercy Hospital in San Diego. They found that delays were most often caused by problems with emergency services or transportation and insurance or registration issues — all factors outside of a hospital’s control.
The study also found that removing any one of these factors would result in an average reduction of about six minutes in the time it takes for stroke patients to receive clot-busting drugs.
To address this problem, researchers created a tool called an early warning system designed to identify technical or financial barriers before they delay treatment.
To address this problem, researchers created a tool called an early warning system designed to identify technical or financial barriers before they delay treatment. The system is called pre-notification, or “wake-up calls.” It identifies obstacles before symptoms start and helps doctors better prepare for possible complications during surgery.
The system works by sending doctors text messages about patients with certain risk factors for stroke before surgeries that require general anesthesia. These include older adults who have diabetes or high blood pressure; women who are pregnant or have migraines; people who take blood thinners like aspirin; smokers over age 40; those at risk of heart disease because of their genetics (if you have a family history of heart disease); and African Americans or anyone else with sickle cell anemia (a genetic condition).
When hospital staff identify such obstacles, they can work on clearing them before symptoms start so patients can get treatment as soon as possible after they arrive at the hospital. This procedure is called pre-notification, or “wake-up calls.”
Pre-notification is a process where the hospital notifies the patient of their arrival time, as well as any obstacles they may face on their way to the hospital. This allows hospital staff to clear those obstacles before symptoms start, which can save time for patients getting treatment.
This is especially important for people with early stroke symptoms because the faster you get treatment, the better your chances of recovery.
Conclusion
The spread of such systems could reduce the number of deaths from stroke by 20 percent, according to the study’s authors. They also wrote that hospitals should be aware that some patients might not seek treatment after experiencing symptoms because they don’t know what’s wrong with them or think their symptoms are just a bad headache or stomachache.