Special Ambulance Delivers Vital Stroke Care More Quickly
(HealthDay News) — Stroke outcomes are better when patients are treated in an ambulance by a neurologist equipped with a computed tomography scanner and tissue plasminogen activator (tPA), according to a report published online November 17 in JAMA Neurology.
Martin Ebinger, MD, from the Center for Stroke Research at Charite-Universitatsmedizin in Berlin, and colleagues looked at how fast tPA could be given before patients got to the hospital and how well they did afterwards. Specifically, they looked at 3,213 patients with a suspected stroke treated in a stroke emergency mobile unit (STEMO) between May 2011 and January 2013, and compared them with 2,969 similar patients when STEMO wasn't available.
The researchers found that, of the 614 patients who suffered a stroke when a STEMO unit was available, 32.6% got tPA in the ambulance. Among the 330 stroke patients seen when the special ambulance was not available, 22% were given the drug once they got to the hospital. Patients treated in the STEMO unit got tPA 24.5 minutes sooner than patients given the drug in the hospital. The number given tPA within the 'golden hour' was six times higher with STEMO. Moreover, patients treated with STEMO had no increase in mortality in the week or three months after their stroke, and they were able to leave the hospital sooner than patients given tPA in the hospital.
"The so-called 'golden hour' is associated with improved patient outcomes in terms of hospital discharge," Ebinger told HealthDay. "Our findings emphasize the importance of fast treatment in acute stroke." Giving clot-busting drugs in a STEMO substantially increases the number of stroke patients who get that care in the golden hour, he said.