Lead author Dr. Opeolu Adeoye, associate professor of emergency medicine and neurosurgery at the University of Cincinnati, said of the more than 370,000 Medicare stroke claims for 2011 that researchers examined, 4 percent received tPA, a drug that can reduce disability if given intravenously within 3 to 4 hours after the first stroke symptoms, and 0.5 percent had endovascular therapy to reopen clogged arteries.
"If a patient suspects they are having a stroke, they need to call 911 immediately and get to the nearest stroke center as soon as possible, which might mean bypassing another hospital that isn't set up to deliver the necessary therapy," Adeoye said in a statement. "We strongly suggest that patients go to the hospital by ambulance, that they or whoever is with them ask to go to a stroke center and ask for tPA."
The study found 81 percent of U.S. adults live with an hour's drive of a hospital capable of administering tPA; 66 percent had access to a primary stroke center; and 56 percent had access to a hospital capable of performing endovascular therapy.
Ninety-seven percent could reach a tPA-capable hospital withnin an hour by air; 91 percent could reach a stroke center, and 85 percent could reach a hospital capable of performing endovascular therapy.
Sixty percent of U.S. hospitals didn't administer tPA in 2011, and discharged about 1-in-5 stroke patients.
"Every 15-minute delay in getting treatment increases the odds of that patient not being able to go home," Adeoye said. "Calling 911 is best if a stroke is suspected because paramedics should know which hospitals are stroke centers and can alert the stroke team in advance of the patient's arrival, all of which saves time."