Avoiding a Late Start in Treating a Stroke

Most people are aware that time to initiation of treatment is critical in getting the best result after a heart attack or a stroke. In the case of heart attack, the long-term benefits of reducing door-to-needle or door-to-balloon times have been shown in a conclusive study. In the case of stroke, a CT (computed tomography) scan is needed to ensure that the lesion is ‘ischemic’ - due to a vessel blockage – and not hemorrhagic, so that the most appropriate treatment can be given. However, the time from initial symptom to having a diagnostic CT is critical, and reasons for delay have been analyzed in a recent study. Reporting in the journal Stroke, North Carolina researchers examined patient and hospital information as predictors of delay time until the all-important CT scan.

Most patients (76% in this study) don’t arrive at the hospital within 2 hours of the stroke onset, i.e. in reasonable time to be assessed for therapies such as the clot-buster tPA, which must be given within 3 hours of the stroke. Of those who arrived within 2 hours, only 24% had a CT scan within 25 minutes. (Blocks of 25 minutes were used to analyze the time delays.) Importantly, those patients who arrived by ambulance were more than twice as likely to receive a timely CT scan than those who walked in or were brought by a friend or family member. Other reasons for a timely CT scan were if the hospital had a Primary Stroke Center, or if the patient was male. On a positive side, race, health insurance status, time of day, or weekday vs. weekend made no difference.

Readers can make a difference if they recognize the warning signs of a stroke, and call 911. Hospitals can improve things if they open a Primary Stroke Center , or at the very least organize the path from emergency department to CT scan (and reading it) with priority efficiency. If this all sounds familiar, it should be. I’ve just found out I’ve posted most of this stuff before, a year ago, but we didn’t have the N. Carolina study then.

Comments

[duerieTef]

Hello.
:) Watched attentively by big sisters Maud and Leah the newest member of the Norwegian royal family has been captured in homely shots used by proud parents Princess Martha Louise of Norway and her husband Ari Behn to introduce her to the world.
Bye.