Time is of the essence for stroke victims
Embargoed until 12.00 Noon Sunday 6 April 2003
Most patients with stroke arrive at hospital too late to receive new effective treatments, according to research in the latest edition of the Medical Journal of Australia.
Recovery from ischaemic stroke can be greatly enhanced in selected patients if new anticlotting therapy is given within three hours of stroke onset. However, as the therapy can have serious side effects in some patients and types of stroke, patients must be carefully assessed before receiving it.
Co-authors of the research, Dr Philip Thompson, Professor of Neurology at the University of Adelaide and Royal Adelaide Hospital, and Dr Simon Broadley, Advanced Trainee at the hospital, say many people who would otherwise qualify for thrombolytic therapy would miss out because of delays in getting to hospital.
"Both health professionals and the general public need to be more aware of stroke as a medical emergency to ensure early arrival at hospital," said Professor Thompson.
"Assuming the time required for investigations, hospital admission and obtaining consent can be reduced to about an hour, patients must arrive at hospital within two hours of the onset of symptoms if they are to be eligible for thrombolysis therapy.
"However the study conducted at the Royal Adelaide Hospital Stroke Unit showed that, of the 203 patients admitted with ischaemic stroke, only 37 could have been considered for the new therapy.
"To qualify, patients must be diagnosed with non-severe but disabling ischaemic stroke and they must be admitted to hospital within three hours of the onset of the stroke.
"Few people are aware of the importance of recognising warning symptoms of stroke. This failure to recognise stroke symptoms is a significant cause of delay for stroke victims getting to hospital.
"Further study is needed in Australia to determine the origin of referral to hospital, mode of transport and priority of triage on arrival at hospital.
"The timely diagnosis and treatment of stroke may require the availability of 24-hour acute neurological assessment and interventional services.
The Medical Journal of Australia is a publication of the Australian Medical Association.
CONTACT: Professor Philip Thompson, 08 8222 5502 (Monday morning only)
Judith Tokley, AMA, 0408 824 306