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Study: Hospitals Too Slow With Stroke Scans

May 9, 2012
Written by: , Filed in: Diagnostic Imaging, Emergency Radiology
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Hospitals are not giving brain scans to stroke patients within the recommended 25 minutes after their arrival, according to a study published this month in the journal Stroke.

Every second counts in minimizing brain damage for stroke patients. So the American Heart Association (AHA) created a quality-improvement program called Get with the Guidelines, with 1,199 enrolled hospitals at the time of the study. The researchers used Get with the Guidelines data for 40,777 stroke patients who were candidates for the tissue plasminogen activator  (tPA) clot-busting drug. They had a clot-related ischemic stroke, they had arrived at the hospital within three hours of symptom onset, and they had no other conditions that precluded the use of tPA.

The AHA guidelines call for CT or MRI imaging within 25 minutes of hospital arrival to confirm the diagnosis of stroke and determine whether it’s ischemic or hemorrhagic. But the study found that only 41.7 percent of suspected stroke patients actually received scans within that time. Adam Kelly, MD, the lead author, said:

We were struck by the fact that more than half of patients with acute stroke symptoms did not receive a brain scan within recommended guidelines. This was the performance of hospitals who are actively participating in a national quality improvement program, so rates in nonparticipating hospitals may be even worse.

Dr. Kelly is a University of Rochester Medical Center neurologist. He was quoted in a medical center news release.

Some of the same researchers were involved in another study, this one published online April 26 in Stroke, also using Get with the Guidelines data. It found that more than one fourth of ischemic stroke patients arrived at a hospital within the three-hour window during which tPA use is most effective at saving brain cells.

However, that percentage remained unchanged over the six-year period of the study. The study concluded: “Further efforts are needed to increase the portion of patients with acute ischemic stroke presenting within the time window for acute interventions.”

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In Berlin, Germany, emergency workers take treatment to stroke patients rather than the other way around. Learn about Berlin’s CT-equipped stroke ambulance on our Facebook page.

Related seminar: Emergency Radiology

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