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Stroke Patients Benefit from Mode of Transportation

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Posted: 3/1/2006

COLUMBUS, Ohio—When it comes to a stroke, the method by which patients arrive at the hospital is often as important as the medical care they receive once they get there.

Stroke patients who arrive at an emergency department by an ambulance are more likely to be treated sooner than stroke patients who arrive by alternative modes of transportation, according to a neurologist at The Ohio State University Medical Center.

Dr. Yousef M. Mohammad led a study to determine how stroke patients are treated in relation to how they arrive at the emergency department.

“The reason stroke patients need to be transported immediately is there are medicines that can only be given within a few hours of the stroke. If a patient presents beyond three hours, then they’ll miss this window of opportunity for this treatment,” said Mohammad.

Mohammad also found that less than 1 percent of the stroke patients who need the clot-busting drug, TPA, actually received it. To be effective, the drug must be administered within three hours of the onset of the first stroke symptoms. However, most patients do not get to the hospital in time.

The study consisted of the review of medical records of more than 630,000 stroke patients who were categorized into three groups based on their modes of arrival: ground or air ambulance, walk-in or private vehicle, and public services such as a police car.

Researchers found that 331,760, or 53 percent, arrived by ambulance; 271,268, or 43 percent, were walk-ins or arrived by private vehicle; and 27,374, or 4 percent, arrived by public service or unspecified transportation.

According to the study, a physician treated patients who arrived in an ambulance within 30 minutes of their arrival, compared to 34 minutes if patients walked in and 55 minutes for patients who arrived by public service or unknown transportation.

“Time is brain and every minute counts in stroke. There is treatment for stroke, effective treatment, but this has to be administered urgently. So every minute counts here,” said Mohammad.

Based on how they arrived, stroke patients arriving by ambulance were more likely to be admitted to the hospital. Ninety-three percent of the patients who arrived by ambulance were admitted, while only 58 percent of walk-in patients were admitted. Only 52 percent of those who arrived by public or unknown transportation were admitted.

Finally, the study showed that a physician saw 97 percent of stroke patients who arrived by ambulance, compared to 89 percent of patients who walked in and 82 percent of patients who arrived by public or unknown transportation.

The research concluded that stroke patients who arrived by ambulance received a higher level of care, but there is still a large portion of stroke victims who are not arriving by ambulance. More effort is being put into increasing the number of stroke patients that arrive by an ambulance.

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Nicole Mazur
Medical Center Communications

Emergency Services; Neurology; OSU Medical Center; Researchers; Stroke; University Hospital; University Hospital East