DALLAS, March 11, 2021 – For every 10-minute delay between arriving at the emergency room (ER) and starting stroke treatment, patients with severe strokes can lose eight weeks of healthy living, according to a preliminary study presented at the American Stroke Association International Stroke Conference 2021. The virtual meeting is March 17-19, 2021 and is a major global meeting for researchers and clinicians dedicated to the science of stroke and brain health.
Delays between the onset of stroke symptoms and hospital arrival have long been known to cost lives and brain cells.
“Our study showed that delays in hospital treatment could have a worse impact on stroke recovery than delayed prehospital treatment,” said lead study author Mohammed A. Almekhlafi, MD, M.Sc., vice president professor of clinical epidemiology, radiation and community health sciences in the School of Cumming Medicine at the University of Calgary in Canada.
To examine the speed of in-hospital stroke care, researchers examined the time between the arrival of ER to the start of mechanical clot removal treatment among 406 patients who participated in seven stroke tests between -national (High-Effective Reversal Assessed in Endovascular Throat Tests – HERMES) compares mechanical clot resection (endovascular thrombectomy) with or without clot-busting medication to clot-medication alone. The seven studies were published between 2010 and 2015 with different start and end dates.
Their stroke clots were removed at complete stroke centers as participants in one of the seven international clinical trials. All patients in this sub-analysis had a major stroke with obstruction of one of the major brain arteries, and all were treated within four hours of known time. they finally had them well. Outcomes were measured in terms of lost healthy years of life, an indicator of quality of life after stroke that considers patient life expectancy and the extent of post-stroke disability.
The researchers found:
- The median time between the start of the signal and the arrival of the ER was just over three hours at 188 minutes.
- The median time between ER and artery arrival was painted to initiate the clot removal procedure by more than an hour and a half at 105 minutes.
- After every hour in hospital 11 months of healthy living were lost.
- After each 10-minute delay in hospital eight weeks of healthy living were lost.
“I was surprised by the extent to which hospital delays affected stroke outcome even in those who arrived early in hospital after stroke symptoms,” Almekhlafi said.
After patients with a stroke come to the emergency room of a complete stroke center, they should be evaluated by members of the stroke team and torn into brain images to confirm the stroke diagnosis and to site. identify the obstruction in the cerebral vessels. If appropriate, clot prevention medications will be given as soon as possible. Patients are then taken to a dedicated operating room for the emergency endovascular treatment.
“Delays may occur if brain scanners or angiography centers are taken by another patient when the patient arrives for a stroke, or if there is a delay in notifying or reaching the endovascular team to the hospital (such as during night hours or weekends), ”Almekhlafi said.
Many national and international professional bodies including the American Stroke Association have proposed criteria to monitor the time from arrival in an emergency room until blood flow is restored to the underlying brain artery. prevented to reduce the risk of severe disability and death.
“Our findings underline the importance of continuous monitoring of these time measures to ensure that the pace of care is maximized,” said Almekhlafi.
The limitation of the study is that all patients were taken directly to a complete stroke center capable of delivering endovascular treatment. Delays may have a different effect on those assessed in the ER at a community hospital and then transferred to another hospital or a complete stroke center for endovascular treatment.
“Rapid and emergency delivery of stroke care is critical for all stroke patients to reduce the risk of death and severe disability,” said Almekhlafi.
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Co-authors are Mayank Goyal, MD, Ph.D .; Diederik WJ Dippel, MD; Charles BLM Majoie, MD, Ph.D .; Bruce CV Campbell, MD; Keith W. Muir, MD; Andres M. Demchuk, MD; Serge Bracard, MD; Francis Guillemin, Ph.D .; Tudor G. Jovin, MD; Patrick Mitchell, MD; Philip White, MD; Michael D. Hill, MD, M.Sc .; Scott Brown, Ph.D .; and Jeffrey L. Saver, MD The authors’ publications are listed in the abstract.
The study was funded by an unrestricted grant from Medtronic to the University of Calgary, the HERMES Coordination Center.
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The American Stroke Association (ISC) International Stroke Conference is the world’s premier meeting dedicated to the science and treatment of cerebrovascular disease. ISC 2021 will be held almost March 17-19, 2021. This 3-day conference will feature over 1,200 compelling presentations in 21 areas that emphasize basic, clinical and translational sciences such as which they lead to a better understanding of stroke pathophysiology with the goal of developing more effective treatments. Participate in the International Stroke Conference on social media through # ISC21.
About the American Stroke Association
The American Stroke Association is committed to saving people from stroke – the number 2 leading cause of death in the world and the leading cause of major disability. We work with millions of volunteers to fund innovative research, fight for stronger public health policies and provide life-saving tools and information to prevent and treat stroke. The Dallas-based association was officially launched in 1998 as a division of the American Heart Association. To learn more or get involved, call 1-888-4STROKE or visit stroke.org. Follow us on Facebook, Twitter.
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