Michigan Medicine study finds disparities in stroke care leading to avoidable complications

Researchers from the University of Michigan and the University of Chicago have discovered significant delays in stroke care leading to avoidable complications, according to an announcement.

The disparities come from patient transfer delays, the study found. Several (>40%) patients are seen at hospitals that do not offer endovascular therapy when experiencing a stroke, requiring them to be transferred to a hospital that does. Extended transfer time can lower patient survival rate and “increases their chances of leaving the hospital with significant disability.”

Key findings from more than 20,000 acute ischemic stroke patients:

• Only about one quarter of patients were transferred to a hospital that provides endovascular therapy within 90 minutes, “the maximum time recommended by the American Heart Association.”
• When transferred in 91 minutes-three hours, patients had a 29% lower chance of getting needed treatment.
• If transfer time reached four and a half hours or higher, a patient’s chance of receiving a thrombectomy declined by 65%.
• The longer the transfer took, the higher the patient's disability risk and chances of walking were.

Furthermore, previous data from the AHA’s Get With the Guidelines-Stroke registry revealed that “the median door-in-door-out time for stroke patients was nearly three hours.”

The study authors call for enhanced stroke care and lower transfer times. A current NIH-sponsored clinical trial is reviewing intervention methods.