A new study has revealed that close to 75 per cent of acute stroke patients are waiting more than two hours to be transferred to a comprehensive stroke centre, increasing their risk of long-term disability.
“In neurology, we often say that “time is brain.” For every 15 minutes that pass without treatment, prior research shows there is a steady decrease in the chances of good outcomes for stroke patients,” says Shyam Prabhakaran, MD, MS, James Nelson and Anna Louise Raymond Professor and Chair of the Department of Neurology at UChicago and senior author on the study. “Getting to the right hospital quickly can be lifesaving.”
Through analysing recent data from over 100,000 patients in 1,925 hospitals across the United States, the researchers discovered that the median time between initial arrival and departure for transfer was 174 minutes. Almost three in four patients wait longer than the recommended maximum of 120 minutes.
These intervals do not include the subsequent transport time between hospitals, meaning that it can be three or more hours before a patient receives critical interventions such as a thrombectomy.
Furthermore, the data revealed that patients who were elderly, Hispanic, Black or female were more likely to have increased arrival to departure times than their counterparts. Although many factors such as variations in disease presentation could contribute to these differences, Prabhakaran says the results should prompt greater focus on health equity when it comes to stroke care.
Prabhakaran, says: “Our findings expose disparities that shouldn’t exist.
“If you’re having a stroke, it doesn’t matter if you’re a man or a woman or black or white — you should be able to get the same care.” He urged healthcare providers and policymakers alike to be vigilant against and combat systemic biases that exist in healthcare.”
However, Prabhakaran emphasises that arrival to departure times are too high across the board, and that healthcare systems and patients should work together to bring them down.
The data did, however, uncovered multiple factors that lowered arrival to departure times. When emergency medical services (EMS) called ahead to notify medical centres that stroke patients were en route via ambulance, for example, median arrival to departure times were reduced by around 20 minutes.
Prabhakaran, says: “If you’re a patient, one of the lessons from this is that calling emergency services has immediate benefits, not only for stabilising you but for the downstream effects that it carries.
