Time to Computerized Tomography Scan, Age, and Mortality in Acute Stroke

Area of Science:

• Neurology
• Medical Imaging
• Public Health

Background:

• Timely hyperacute management in stroke is crucial and relies on prompt computerized tomography (CT) scans.
• Evaluating the impact of age and CT scan time on mortality outcomes is essential for stroke care.

Purpose of the Study:

• To assess the relationship between patient age, time to CT scan, and mortality outcomes in stroke patients.
• To determine if time to CT scan is a suitable quality marker for stroke care.

Main Methods:

• Utilized routinely collected data from 8 National Health Service trusts (September 2008 - April 2011).
• Analyzed prospectively identified and confirmed stroke cases, calculating odds ratios for age and time to CT categories.
• Examined in-hospital and early (<7 days) mortality outcomes.

Main Results:

• Older patients and those from care homes experienced significantly longer times to CT scans.
• Earlier CT scans correlated with more frequent admission to stroke units but higher in-patient and 7-day mortality.
• Longer times to CT scans were associated with significantly reduced 7-day and in-hospital mortality.

Conclusions:

• Older age is associated with increased time to CT scans in stroke patients.
• Time to CT scan may not be a reliable quality marker for stroke care due to inherent limitations.
• The study highlights the complex interplay between age, diagnostic timing, and mortality in stroke management.