Delay between emergency room arrival and stroke consultation

We reviewed retrospectively the charts of all stroke patients admitted through our emergency room (ER) during the first halves of 1986 (Group A) and 1992 (Group B). Specifically, the time elapsed between ER arrival and the request for consultation by neurology or neurosurgery was subjected to comparison by analysis of variance. In Group A, the time elapsed from arrival to consultation request varied between 1 and 100 min (mean, 32.5). In Group B, the same period ranged from 2 to 285 min (mean, 84). The difference in mean elapsed time between the two groups was statistically significant (<0.0001). In Group A, patients with hemorrhagic events had significantly shorter delay between arrival and consultation (p = 0.026). This was not the case in Group B. Stroke type did not influence the time to consultation in Group A (p = 0.18) orGroupB (p = 0.60). The results show that neurologic and neurosurgical consultations of stroke patients in the ER are delayed more now than in the past. This finding may have a significant impact on acute stroke intervention trials and underscores the need for active collaboration between stroke specialists and emergency physicians.