Healthcare News & Insights

New study: Faster stroke care = Better recovery

A new study found that hospitals that emphasize faster stroke care, including giving a clot-busting medication within the first hour of arriving at the facility, send more patients straight home. 

Stroke wordcloud glowingTo date, the study, which was recently published in JAMA, provides some of the best evidence that hospitals can speed up stroke care and produce better outcomes by adopting a few key strategies:

  • Having ambulance workers send alerts when stroke patients are en route to the hospital, and
  • Doing brain scans, lab tests and medication mixing as soon as patients arrive at the hospital.

Minutes count

Conducted in more than 1,000 hospitals, the study is “more evidence that for stroke, every minute counts,” lead author Gregg Fonarow, a heart specialist at the University of California-Los Angeles, told USA Today.

And if patients don’t arrive in time to benefit from the medication — tissue plasminogen activator (tPA) — all efforts will be wasted. According to the study, guidelines call for giving tPA within 4.5 hours of symptom onset and within an hour of arrival at a hospital.

Researchers examined 71,169 patients with ischemic strokes. They compared those treated in 2003-2009 with those treated in 2010-2013 after the facilities adopted improvement programs developed by the American Stroke Association and other groups.

Positive results

“In the course of this study alone, thousands of lives were saved,” and thousands more avoided costly nursing home care, noted Fonarow.

Here’s why: The number of patients who got the tPA drug within an hour of arriving at the hospital rose from 26% to 41%, and eventually reached 53% by the end of the study. And the median time elapsed fell from 77 minutes to 67 minutes.

Other positive results include:

  • Among those patients treated, in-hospital deaths fell from 9.9% to 8.2%.
  • More patients were discharged from the hospital able to walk (45.4% vs. 42.2%), and
  • More went home to recover (42.7% vs. 37.6%).

When you consider the fact that there are 800,000 strokes a year and 87% of them are ischemic, that’s a lot of lives being saved.

More research needed

While the study does put increasing the speed of stroke care in a positive light, more research is needed to prove the improvement programs are cost effective.

The researchers did note that patients play a big role in stroke care, too. In this study, as it was in previous studies, most patients didn’t receive the critical tPA medication because they didn’t arrive to the hospital on time.

So emphasize with your at-risk patients and their families how important it is to recognize the signs of a stroke.

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