Stroke Deadline Missed by Many

Only a small fraction of people who are undergoing a stroke arrive at a hospital within the necessary three hours needed to receive recombinant tissue plasminogen activator (tPA), which can dissolve the clot and reduce the chance of permanent disability.

In a study involving 15 hospitals in Michigan, researchers identified everyone who was admitted to the hospital with a stroke over a six-month period. Of the 2,097 people who had strokes involving blood clots, only 43 people, or 2%, received the clot-busting drug. Of those who did not receive treatment, 41% arrived at the hospital more than three hours after the first symptom started. For another 38%, there was no information available about when the symptoms started. The study was published in the February 14, 2006, issue of Neurology.

Several factors increased the chances that tPA would be given. Those who arrived at the hospital by ambulance were seven times more likely to receive tPA than those who arrived on their own. Women were 60% less likely to receive tPA than men, and the sooner people arrived at the hospital within the three-hour window, the more likely they were to receive tPA. Of those who did arrive within three hours and did not receive the treatment, the two main reasons for not giving tPA were that the patient's condition had improved significantly, or that the stroke was considered too mild to require treatment.

"It's very important to be able to tell the medical staff when the symptoms started, said study author Mathew Reeves, Ph.D., of Michigan State University (East Lansing, USA). It could mean the difference between receiving treatment and not receiving treatment.



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