Race, age, income and health insurance status are factors in the distance patients must travel to reach the nearest certified stroke care, according to a nationwide analysis of US census data and road maps. The greatest distances were for those in rural areas and for American Indians.
Treatment for ischemic stroke, a blockage in an artery that supplies blood to the brain, restores blood flow to the brain. Rapid treatment is essential to reduce disability. Blood flow may be reestablished by administering intravenous clot-busting medication within 4.5 hours after the onset of stroke symptoms and ideally within one hour after hospital arrival. All certified stroke centers offer treatment with clot-busting medication as well as being staffed by medical professionals trained in stroke care and employ other measures to improve stroke care .
«Every day, those of us who treat stroke face the reality that our desire to help everyone competes with the fact that millions of Americans cannot reach us in time,» said senior study author Akash Kansagra, M.D., M.S., associate professor of radiology, neurological surgery and neurology at Washington University School of Medicine in St. Louis. «Stroke patients have a much better chance of recovery if they can get to a stroke hospital quickly. The question we wanted to address was whether certain Americans have to travel farther than others to receive the expertise that might save them if they have a stroke.»
The 2019 American Heart Association/American Stroke Association guidelines recommend stroke patients be taken by emergency medical services to the nearest stroke-capable hospital, as well as using interactive videoconferencing to provide acute stroke care, also known as «telestroke,» for patients in remote settings.
The American Heart Association with the Joint Commission collaborate to provide hospitals Acute Stroke Ready Certification, Primary Stroke Certification, Thrombectomy-Capable Stroke Certification and Comprehensive Stroke Certification to qualifying hospitals.
Researchers used a public mapping service to compare the road distance to the nearest certified stroke center for each census tract (small geographic areas defined for the U.S. census) in the 48 contiguous states and the District of Columbia. For each census tract, they gathered data from the U.S. Census Bureau’s 2014-2018 American Community Survey on age, race, ethnicity, medical insurance status, income and population density. The analysis covered 98% of all U.S. census tracts, which include more than 316 million people and more than 2,300 stroke-certified hospitals.
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Materials provided by American Heart Association. Note: Content may be edited for style and length.