Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, October 16, 2014

In-Hospital Stroke Patients Wait Longer for Care

Once again we have doctors/researchers that don't keep up with published research. This was written up in May, 2013.

In-hospital strokes get worse care than those presenting to ER, study finds

Pretty much the same study in Canada

In-Hospital Stroke Patients Wait Longer for Care

Up to 17% of strokes occur in patients already hospitalized, but a new Canadian study shows that they wait longer for neuroimaging and thrombolysis than those who have a stroke at home and are brought to the emergency department (ED).
Doctors in hospitals should keep stroke on their radar in the same way that they do for a heart attack, lead study researcher, Alexandra Saltman, MD, resident, core internal medicine, University Health Network, University of Toronto, Ontario, Canada, told Medscape Medical News. "They should keep an open mind that some subtle symptoms may represent stroke, and if they're worried, they should act on it quickly."
Dr Saltman presented the study at the Canadian Stroke Congress in Vancouver, British Columbia.
"Shocking Difference"
For the study the investigators gathered data from charts for all adults with stroke at 11 regional stroke centers in Ontario, Canada, from 2003 to 2012. This included 1048 patients who were admitted to the hospital with another condition and had a stroke while there, and 32,227 who were brought to the hospital after sustaining a stroke. Most hospitalized patients were admitted for medical reasons (30%) or surgery other than cardiac (30%).
The mean age for the entire cohort was 73 years.
To compare "in hospital" and "community-onset" strokes, the authors used the Heart and Stroke Foundation's Canadian stroke best practice recommendations and the American Heart Association (AHA) best practice guidelines for stroke care.
The study results showed that in-hospital patients waited an average of 4.5 hours from the time symptoms were recognized to undergo computed tomography compared with 1.3 hours for patients brought to the ED.
"To me that's a shocking difference," said Dr Saltman.
About 29% of in-hospital stroke patients met the "benchmark" best practice of getting thrombolysis within 90 minutes of symptom onset compared with 72% of patients coming from the community, said Dr Saltman.
In addition, the in-hospital group was less likely to receive thrombolysis (12%) than the group admitted after having a stroke outside the hospital (19%), even if they were eligible for this intervention, she added.
In-hospital patients stayed longer in the hospital (17 days vs 8 days), were more likely to be discharged to a rehabilitation facility (40% vs 32%), and were less likely to be sent home (35% vs 44%).
Although the "in-hospital" patients had more vascular risk factors and comorbidities than the "in-community" group, researchers adjusted for these factors. "We accounted for age, sex, all the vascular comorbidities, stroke severity, and type of stroke, and even when we account for those factors, the in-hospital patients still did worse," said Dr Saltman.

Another page at the link.

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