ASA: 'Golden Hour' Stroke Patients More Likely to Get tPA

But stroke patients who arrive at busiest times are likely to face delays in receiving care
By Rick Ansorge
HealthDay Reporter

WEDNESDAY, Feb. 18 (HealthDay News) -- At hospitals participating in the Get With The Guidelines-Stroke program, patients who arrive within one hour of symptom onset (the "golden hour") are twice as likely to receive tissue plasminogen activator (tPA) as those who arrive with one to three hours. But hospital overcrowding can lengthen the time it takes stroke patients to receive needed care, according to two studies presented at the American Stroke Association's International Stroke Conference held Feb. 17 to 20 in San Diego.

In one study, Jeffrey L. Saver, M.D., of the University of California Los Angeles, and colleagues reviewed records of 106,924 ischemic stroke patients treated at 905 hospitals and found that 28.3 percent arrived within one hour of symptom onset compared to 31.7 who arrived within one to three hours, and 40.1 who arrived after three hours. The researchers found that significantly more patients who arrived within one hour received tPA than those who arrived within one to three hours (27.1 percent versus 12.9 percent).

In a second study, Jane Brice, M.D., of the University of North Carolina at Chapel Hill, and colleagues assessed data on 457 stroke patients, including 166 who arrived during the busiest time periods. The researchers found that those who arrived during the most crowded time periods experienced significantly longer wait times compared with those who arrived during non-overcrowded time periods: between triage and emergency department room placement (42.13 minutes versus 14.78 minutes), triage to physician assessment (92.4 minutes versus 53.3 minutes), and triage to hospital bed requested (372.85 minutes versus 294.21 minutes).

"These findings support public education efforts to increase the proportion of patients arriving within the first 30 to 60 minutes after stroke onset," Saver said in a statement.

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