Many Miss Out on Stroke Treatment

Less than quarter of victims get to hospital quickly enough to limit damage, study shows

By Ed Edelson
HealthDay Reporter

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THURSDAY, Aug. 7 (HealthDay News) -- Most people who have strokes don't act quickly enough to get the clot-dissolving treatment that can limit brain damage, a new study finds.

"One of the problems is that a lot of people don't realize that they are having a stroke," said Kathryn M. Rose, a research associate professor of epidemiology at the University of North Carolina, and author of a report in the Aug. 8 online issue of Stroke. "There still needs to be a lot of education in the community for people to recognize these symptoms, and when you recognize them, call 911."

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Hospital personnel can share some of the blame for tardy treatment, Rose added. "There is also delay time among people who get to the hospital quickly, so there is room for the medical community to act," she said.

Rose and her colleagues studied data on 15,117 people treated for strokes at 46 hospitals in North Carolina between 2005 and 2008. Treatment for an ischemic stroke, in which a clot blocks a blood vessel in the brain, is injection of clot-dissolving tissue plasminogen activator (tPA), but that is effective only in the first three hours after a stroke occurs.

In practice, that means arriving at a treatment center within two hours, Rose said, because, "once you get there, you need to be diagnosed. There's a very narrow window in which you can get treatment."

Only 23 percent of the people in the study arrived at hospitals within two hours of the onset of symptoms. The recommendation is that someone suspected of having a stroke should have a computerized tomography scan within 35 minutes to confirm the diagnosis. Of the 3,549 people who arrived within two hours of symptoms, only 23.6 percent had a CT scan in the recommended times.

"We found that women were less likely to get timely treatment," Rose said. "Also, treatment was faster in hospitals that were certified stroke centers, which have a formal plan for diagnosis and treatment."

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