More Australian hospitals are delivering timely life-saving stroke treatments to patients—and, collectively, the country’s hospitals have recorded the fastest stroke response times—since national target priorities were set in 2023 to improve acute stroke care, and reduce avoidable death and disability. However, potentially “concerning” discrepancies in stroke care have been revealed across different age groups and locations too.
The Australian Stroke Clinical Registry (AuSCR)—a collaborative partnership between the Florey Institute of Neuroscience and Mental Health (Parkville, Australia), Australian Stroke Foundation, Australian and New Zealand Stroke Organisation (ANZSO) and Monash University (Melbourne, Australia)—monitors the performance of hospitals against national stroke treatment priorities.
The AuSCR’s latest annual report includes data for 2024 from 69 hospitals on almost 18,000 patients who were either admitted or presented to emergency departments.
One of the national targets tracked annually by the AuSCR partnership is thrombolytic ‘door-to-needle’ time—the number of minutes it takes to administer intravenous clot-busting therapy to a patient.
In 2024, the median door-to-needle time fell by six minutes, from 73 to 67 minutes, compared with the previous year. However, of the 62 Australian hospitals that provide thrombolytic therapy, only 11 met the national recommended door-to-needle target of under 60 minutes.
Ultimately, around 13% of patients with stroke received clot-busting therapy, and 43% of this group were treated within the target time of less than one hour.
“Based on published evidence, reducing the door-to-needle time by six minutes may provide an estimated 11 additional healthy days per patient, equating to approximately 47 extra years of healthy life for this group of patients,” said Dominique Cadilhac (Monash University, Melbourne, Australia), the AuSCR’s executive director. “This improvement also means an estimated 25 patients have potentially avoided significant disability.”
According to the AuSCR, this positive trend looks set to continue with a provisional door-to-needle time of 62 minutes based on 2025 data up to 29 November last year.
“The hard work of clinicians to drive down their door-to-needle times is commendable,” Cadilhac added.
The AuSCR’s report also revealed differences between the experiences of patients aged 18–55 years who have had a stroke in contrast to older patients.
These younger patients were less likely to go to hospital by ambulance, less likely to be prescribed secondary prevention medications, less-often offered inpatient rehabilitation services, and more likely to be discharged home.
“Some of these findings are concerning and need further investigation to ensure that young people are receiving appropriate stroke care,” Cadilhac commented.
The Florey Institute of Neuroscience and Mental Health notes in a press release that it runs Australia’s first health service dedicated to helping young stroke survivors—the Young Stroke Service (YSS)—in the regions of Victoria and South Australia.
“YSS works with young people who have had a stroke, as well as their supporters and health professionals, and we offer a range of supports to help young people in their recovery to help address the unmet needs young stroke survivors face in their recovery,” said YSS co-lead investigator Vincent Thijs (University of Melbourne, Melbourne, Australia). “By giving young people access to trusted information and practical tools, we’re helping them regain control and rebuild their futures.”
The report further highlights Victoria’s Latrobe Regional Hospital (Traralgon, Australia) as an example of how median treatment times can be sped up through quality improvement activities. Based on provisional data from the first quarter of 2025, the hospital cut its door-to-needle time from 74 to 58 minutes, representing a total reduction of 16 minutes.
However, the AuSCR also found stroke patients receiving treatment in regional hospitals in 2024 were 76% less likely to receive treatment in a specialist stroke unit compared with patients in metropolitan hospitals.
“Unfortunately, the difference between strong recovery or lengthy rehabilitation can come down to where someone lives, and their treatment hospital,” Cadilhac added.
Finally, the AuSCR relays that one in five stroke patients treated in 2024 died. Additionally, three-to-six months after treatment, roughly one third of patients reported having moderate-to-severe disability, while approximately half of all patients experienced other ongoing issues, including anxiety, depression or problems undertaking usual activities.
The full report from the AuSCR can be viewed online here.
