The investigation presented today at the 22nd Annual Meeting of the Neuro -Interventional Surgery Society (SNIS) included three studies that explored the differences in the treatment and recovery options for patients in racial, gender and socio -economic lines in a large network of Telestroke in Pennsylvania and a University Medical Center in Rhode Island.
The treatment of Telestroke aims to improve attention for people with stroke symptoms that live far from comprehensive stroke centers, hospitals that offer a complete neuroendovascular care spectrum, with access to always available thrombectomy. This minimally invasive procedure uses a catheter to reopen the blocked brain arteries in an ischemic occlusion of large vessels, the most common type of stroke. Access to more specialized care such as this can improve the chances of recovery of a person after stroke, and Telestroke programs help expand the scope of neuro -interventionalists by allowing patients in rural areas to receive a virtual diagnosis and a treatment recommendation in a hospital closer to home. This type of attention can help address geographical and racial disparities in the treatment of stroke when approaching services to people in historically unattended communities.
In two of the studies discussed today, the researchers reviewed thousands of medical records to see if patient treatment options and the health poster of stroke varied according to race and gender. In the first study, “gender differences in acute results of ischemic stroke within a large network of telescario: a retrospective cohort study,” the researchers reviewed medical records for 7,947 patients with a suspicious ischemic stroke in a large network of Telestroke. Although men and women in the study had the same probability of receiving thrombectomy, only 13% of women received tissue plasminogen activator (TPA), an IV medication that breaks blood clots that cause stroke, while 15% of men did. Both men and women spent similar amounts of time in the hospital to receive treatment and received similar scores from the stroke of the National Institutes of Health at the discharge.
In the second study, “the ethnic disparities in the results of the stroke mitigated by the efficiency of a large network of telescario,” the research team reviewed the records of 2,952 white patients and 1,122 black patients with suspected ischemic stroke that received Telestroke care. The study found that Telettroke networks can help reduce racial disparities in acute stroke care, particularly in the administration of TPA and mechanical thrombectomy. Although immediate attention was equitable among racial groups, the rehabilitation results after stroke still differ, emphasizing the need for greater research on long -term recovery and rehabilitation disparities. Addressing socio -economic barriers and improving access to subsequent attention to stroke will be crucial to achieve truly equitable stroke care.
In the third study, “the effects of the disadvantage of the neighborhood on the performance of the stroke of stroke brain Half of the patients studied had received field triage, which means that emergency medical services could evaluate them in the scene and immediately enrutated a comprehensive stroke center for thrombectomy, and the second half was sent to the nearest hospital and then transferred to a comprehensive stroke center for the procedure.
The team categorized the socioeconomic state of the patients using the area of deprivation index of the area, which calculates how resources or resources are each neighborhood, discovering that patients of all socioeconomic levels that could receive the field triage and immediately enlightened to the correct hospital had better results after the thrombectomy than the patients who then transferred to a spill center. However, for the group of patients who had to be transferred, the team discovered that the most disadvantaged neighborhood patients had a longer wait for thrombectomy and the worst health after stroke.
According to Basel Musmar, MD, the lead author of the first two studies and postdoctoral researcher at the Hospital of the University of Thomas Jefferson in Philadelphia, “it is very encouraging to see that long racial and gender disparities can be potentially mitigated in mitigos using television treatment. Problems to guarantee that gender and racial factors do not prevent people from experiencing optimal results brain “.
We were excited to see how shocking the field triage can be to potentially reduce health disparities after stroke for people throughout the socioeconomic spectrum. With luck, finding the correct uses for this important tool can reduce the time between a stroke and the treatment that makes people return to their lives. “
Joshua Feler, MD, MS, resident of Neurosurgery at Brown University and the main author of the third study
Fountain:
Neuro -interventional Surgery Society
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