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New stroke research: Better outcomes for patients triaged to level 1 stroke centers

A patient being wheeled into a hospital on a gurney. (WJAR){ }
A patient being wheeled into a hospital on a gurney. (WJAR)
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Research out of Rhode Island Hospital, which has the only comprehensive stroke center in Southern New England, now has eye opening documentation of the difference between getting an acute patient to the closest hospital versus the most appropriate hospital.

"Every minute lost can cost the patient a week of independent life," said Dr. Mahesh Jayaraman, director of the Neurovascular Center at Rhode Island Hospital.

Jayaraman is also the lead author of a new study that tracked outcomes for severe stroke patients who were brought directly to a level one stroke center, like his--or to the closest one.

"Rhode Island became the first state in the nation over six years ago to start taking these severe patients and allowing EMS to decide what is the best hospital for them," said Jayaraman. "Massachusetts never changed their EMS protocols so we had a unique comparison where we treat patients from both Rhode Island and from Southeastern Massachusetts. The patients in Massachusetts are going to the closest hospital first and then they have to be transferred to Rhode Island Hospital, whereas, the vast majority of patients in Rhode Island are brought straight to Rhode Island Hospital."

"Over these five and a half years, the time to treat dramatically got faster. Almost an hour saved by coming straight to the comprehensive stroke center at Rhode Island," Jayaraman added.

He points to that every minute saved giving a patient back a week of independent life.

"This is essentially giving every patient we treat back a year of life," said Jayaraman.

The procedure used to clear these severe blockages -- a thrombectomy -- is also cost effective, he said. The earlier it's used, the better. In this study, that added up to a $60,000 per person savings.

"Our research that my colleagues and I performed really confirms that this type of severity-based field triage is really the most impactful ways to reduce time to treatment in densely populated areas such as Rhode Island and Southeastern Massachusetts," said Jayaraman.

Jayaraman said more and more states are adopting this severity-based field triage for stroke; however, Massachusetts has not.

He's hoping that changes soon.

Meantime, it's important to know signs of stroke. It's as easy as remembering BE FAST.

  • B -- loss of balance
  • E -- loss of eyesight
  • F -- face droop
  • A -- Arm weakness in one arm
  • S --Is speech garbled?
  • T -- Get treatment fast.
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