Treatment Delays and Worse Outcomes for Patients With In-Hospital Stroke

So after you are hospitalized with COVID-19, make sure you don't have an in hospital stroke.
Treatment Delays and Worse Outcomes for Patients With In-Hospital Stroke

-Despite increases in reperfusion therapy rates, these patients fare worse than those who have out-of-hospital strokes

by Zeena Nackerdien PhD, CME Writer, MedPage Today 2020-10-21

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Study Authors: Feras Akbik, Haolin Xu, et al.; Amy Y.X. Yu, Michael D. Hill

Target Audience and Goal Statement: Neurologists, hospitalists, emergency department physicians

The goal of this study was to examine trends in the use of intravenous and endovascular reperfusion therapies for treatment of in-hospital stroke.

Question Addressed:

• What were the trends in the use of intravenous and endovascular reperfusion therapies for treatment of in-hospital stroke?

Study Synopsis and Perspective:

Up to 10.8% of all acute ischemic strokes occur in the hospital. Unlike patients with out-of-hospital stroke onset, those who experience a stroke in the hospital are more likely to have contraindications to systemic thrombolysis because they may have been admitted after major trauma, are recovering from surgery, or a variety of other reasons.

Action Points

• Patients with in-hospital stroke onset received treatment at slower rates and had worse functional outcomes compared with those with out-of-hospital stroke onset, despite an increase in use of endovascular therapy and intravenous thrombolysis for these patients, according to a retrospective cohort analysis of a national stroke registry.
• Note that, although patients with in-hospital stroke onset were increasingly recognized and treated with reperfusion therapy, disparities in care persisted, highlighting opportunities to optimize care, including the use of dedicated inpatient stroke protocols.