On World Stroke Day—29 October 2021—physicians from the Get Ahead of Stroke campaign are urging lawmakers to update triage and transport protocols. They are also asserting that, if the nation’s stroke system of care looked more like its trauma triage system, patients would experience less disability and improved survival rates.
Nearly 20% of people who experience a stroke die from their condition, and many more are left permanently disabled. It is also the leading cause of adult disability in the USA, according to a statement from the Society of NeuroInterventional Surgery (SNIS)—the sponsoring organisation for the Get Ahead of Stroke campaign—which adds that, like trauma, better outcomes after a severe stroke depend on how quickly a patient gets appropriate treatment.
“We now have scientifically proven techniques and devices to treat stroke patients by restoring blood flow,” said SNIS president Michael Chen. “Where we have to catch up is in state-level policies that stymie first responders from taking patients to Level 1 stroke centres right away. If we could better organise and centralise state-level stroke triage, more patients could be treated sooner, which directly benefits outcomes.”
In a severe stroke, a clot blocks blood flow to the brain and deprives millions of brain cells of oxygen. As such, removing the clot quickly is key. This can be achieved through mechanical thrombectomy, a minimally invasive procedure that uses a catheter, guided by X-ray, to remove the clot. However, this procedure is best done by a specially trained neuroendovascular care team—which only 10% of all stroke centres are capable of providing, the statement adds.
“The fact is that patients often go to a hospital without thrombectomy capability, and then must be transferred to one that has that capability. This wastes precious time,” added Chen. “The trauma system paved the way for patients to get the care they need immediately. This World Stroke Day, we need to better organise and centralise care for stroke patients too.”
Get Ahead of Stroke is currently working to improve stroke care state-by-state through policy changes in Massachusetts, Pennsylvania and Michigan. Through its public awareness and advocacy activities, the campaign has meaningfully improved on stroke systems in several states, benefitting thousands of stroke patients.