America’s ERs struggle with timely care for stroke patients
Black, Hispanic, and female patients, as well as those over 80 all experienced longer door-in-door-out times compared to white non-hispanic patients, a new analysis showed.
In the world of stroke care, time is everything. At stroke onset, a clot or ruptured blood vessel interrupts blood flow to the brain. Within minutes, brain cells starved of oxygen and nutrients begin to die. Every additional second that passes without blood flow increases the chance that the brain suffers irreparable damage, leading to permanent disability. With enough time, strokes become fatal, and sadly this is not uncommon. Nearly 800,000 Americans die from stroke every year nationwide, making it the fifth leading cause of death in the United States.
Surgical intervention is becoming increasingly common in stroke treatment, so many stroke patients that come to the emergency room will need to be transferred to another hospital with a specialized stroke facility for treatment. One study found that, of nearly 40,000 patients who received a surgery to treat ischemic stroke from 2012 to 2017, close to half required inter-hospital transfer. Guidelines from the Joint Commission and the Brain Attack Coalition recommend that the so-called door-in-door-out time for these patients — the time between presenting to the ER and departing for the next hospital — remains under 120 minutes.
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