Delayed Stroke Treatment Significantly Increases the Risk of Permanent Disability

Stroke                                       
 

In America, Only a Quarter of Stroke Patients Arrive at the Hospital in Time

A recent medical study has warned that delays in transporting stroke patients to specialized hospitals can significantly reduce their chances of surviving without permanent disability and increase the likelihood of them being discharged with significant motor or neurological impairment, according to a recent report published on the scientific website Medicalxpress.

The study, led by researchers from the University of Chicago Medical Center and published in the journal Lancet Neurology, focused on patients with acute ischemic stroke who require an advanced treatment known as endovascular thrombectomy, a highly effective procedure that has revolutionized stroke treatment over the past decade.

Data indicates that approximately one-third of stroke patients are eligible for this treatment, yet over 40% of them initially arrive at hospitals that do not offer this type of intervention, necessitating their transfer to more advanced medical centers. However, the problem, according to the study, is that this transfer often takes significantly longer than medically recommended.

This delay is known as door-in-door-out time, which is the time a patient spends at the first hospital before being transferred. The American Heart Association recommends that this time should not exceed 90 minutes, but the study revealed that this target is rarely met.

Worrying Figures

Researchers relied on data from over 20,000 patients in the United States and found that only 26% of patients were transferred within 90 minutes. Furthermore, patients whose transfer was delayed between 91 minutes and 3 hours saw a 29% decrease in their chances of receiving catheter-based treatment, and when the delay exceeded 4.5 hours, the chances decreased by up to 65%.

Even more alarming, patients who experienced longer delays in receiving treatment were more likely to leave the hospital with severe disabilities, as measured by the Modified Rankin Scale, in addition to experiencing increased complications and a reduced ability to walk independently after treatment.

Dr. Shyam Prabhakaran, chair of the neurology department at the University of Chicago and the study's lead author, says the findings confirm a well-known fact among physicians: "Every minute of delay means the loss of more nerve cells, and every minute saved can improve a patient's chances of functional recovery."

Stroke

He added that healthcare systems have succeeded in recent years in reducing the time required to administer clot-dissolving drugs, but the new challenge lies in expediting patient transfers between hospitals. The study emphasized the need to develop more efficient regional systems, especially in rural areas or those lacking specialized stroke centers.

The researchers also called for improved emergency care and early diagnosis before patients arrive at the hospital, to direct them directly to centers capable of providing appropriate treatment. The study concludes that improving the speed of patient transfer is just as important as the treatment itself, and that saving the brain begins with strict adherence to time, because delays can leave a lasting impact on the patient's life.