Researchers found that stroke patients gained about
two days of healthy life for every minute spared between the onset
of their stroke and when they first received treatment, on average.
"Every 15 minutes you wait, you lose a month of life," Dr. Atte
Meretoja told Reuters Health.
Meretoja is the study's lead author from the Melbourne Brain Centre
at the Royal Melbourne Hospital in Parkville, Australia.
The exact ratio of saved treatment time to healthy days varied by
patient, he and his team found.
Although it's well known that early treatment for strokes is best,
the new study helps highlight how significant even small delays can
be, researchers said.
"We developed that measure so it's easy to remember and that the
general public will understand it," Meretoja said.
He and his colleagues summarized their findings in the journal
Stroke as, "Save a Minute, Save a Day."
There is currently only one treatment approved by U.S. regulators
for ischemic strokes, which are caused by blockages in blood vessels
going to the brain. Usually, the blockage is a result of clotted
blood or fatty deposits known as plaque.
Thrombolysis is the use of a drug known as tissue plasminogen
activator, or tPA, to break up the blockage and allow blood to flow
to the brain. Restoring blood flow prevents the death of brain cells
and improves people's recovery.
The treatment is time sensitive, however. The 60 minutes from the
onset of a stroke is often referred to as the "golden hour" for
treatment, because people treated during that time have much better
odds of completely recovering.
Approximately 800,000 people in the U.S. have strokes every year,
according to the Centers for Disease Control and Prevention. About
87 percent of those are ischemic strokes.
For the new report, the researchers compiled data from two studies
to find how time to treatment is related to how patients fare after
The studies, from Finland and Australia, included 2,258 stroke
On average, the researchers found that patients gained 1.8
disability-free days for each minute shaved off the time to
Middle-aged stroke patients tended to gain about three days per
minute saved, while elderly patients gained one day or less.
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"The magnitude of benefit here is very much aligned with previous
data and analyses we've done looking at the benefits," Dr. Gregg
Fonarow, who was not involved with the new study, told Reuters
Fonarow is co-chief of the University of California, Los Angeles
Division of Cardiology.
"Time is really the most critical factor here in determining the
outcome," he said.
Over time, Fonarow said hospitals have improved the time they
take to get patients treatment. But there has been little success in
shortening the time it takes for people to recognize they're having
a stroke and get to a hospital.
Many organizations promote the FAST pneumonic device to remember the
symptoms of a stroke: Face drooping, Arm weakness, Speech difficulty
and Time to call 911 after any symptom.
"We continue to need to strive to educate the population regarding
the benefits of seeking care as quickly as possible after suspecting
stroke," said Dr. Robert Brown, a stroke specialist at the Mayo
Clinic in Rochester, Minnesota.
Brown, who was not involved with the new study, said the finding
that every minute counts is also a reminder to doctors and medical
staff to evaluate their practices in an effort to save time once the
patient arrives at the hospital.
"I think this is also very enlightening and energizing to providers
who are constantly thinking of ways to improve," he said.
Stroke, online March 13, 2014.
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