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Delay between emergency room arrival and stroke consultation.

M M Malik1, C R Gomez, R Tulyapronchote

  • 1From The Souers Stroke Institute, Department of Neurology, Saint Louis University Medical Center, St. Louis, MO, U.S.A.

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Summary
This summary is machine-generated.

Emergency room stroke consultations are significantly delayed compared to the past. This delay impacts acute stroke intervention trials and highlights the need for better collaboration between emergency physicians and stroke specialists.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Emergency Medicine

Background:

  • Stroke patient care pathways in emergency rooms (ERs) are critical for timely intervention.
  • Evaluating temporal trends in emergency stroke care is essential for improving patient outcomes.

Purpose of the Study:

  • To compare the time from emergency room arrival to neurology or neurosurgery consultation for stroke patients between 1986 and 1992.
  • To identify factors influencing consultation delays in stroke patients.

Main Methods:

  • Retrospective chart review of stroke patients admitted to the ER during the first half of 1986 (Group A) and 1992 (Group B).
  • Statistical comparison using analysis of variance to assess the time elapsed between ER arrival and consultation request.
  • Analysis of stroke type (hemorrhagic vs. other) and its impact on consultation delay.

Main Results:

  • The mean time from ER arrival to consultation significantly increased from 32.5 minutes in 1986 to 84 minutes in 1992 (p < 0.0001).
  • In 1986, patients with hemorrhagic stroke had shorter delays to consultation (p = 0.026), but this was not observed in 1992.
  • Stroke type did not significantly influence consultation time in either year (p = 0.18 in Group A, p = 0.60 in Group B).

Conclusions:

  • Neurologic and neurosurgical consultations for stroke patients in the ER have experienced significant delays over time.
  • These delays may negatively impact acute stroke intervention trials.
  • Enhanced collaboration between stroke specialists and emergency physicians is crucial to address these growing delays.