Tuesday, September 20, 2016

What are your odds of the right stroke treatment?

You can read my story here and an update here. But in a nutshell, I wound up in the right place and the right time when my stroke occurred back in 1998, two years after tissue plasminogen activator was approved for stroke patients - a Southern community hospital, of all places.

More than 18 years later, we still have problems getting this medication to stroke patients. Kaiser Health News noted geographic and racial disparities in stroke treatment tracked in a new study:
The findings come from a report published Wednesday in the journal Neurology. Researchers found stroke patients living in the Northeast states had more than twice the odds of receiving tPA — a powerful anti-coagulant that can break up the clot causing the stroke — than those living in the Midwest and the South.
The researchers also found race also played a role in determining the patients who received treatment. African-Americans who were evaluated for stroke severity were 26 percent less likely to get the medication. Other minorities faced 17 percent higher odds of not securing the drug.
Overall, a quarter of patients eligible for the medication did not receive it.
The Los Angles Times focused on women and minorities less likely to get key stroke treatment, even when they're eligible:
If you’re having an ischemic stroke, it’s crucial that you get to a hospital fast so you can be treated with a clot-busting medicine. And to improve your odds of getting that medicine, it helps to be a white man.
A new analysis of more than 60,000 stroke patients from around the country found that women were less likely than men to receive an infusion of tissue plasminogen activator, the drug that’s considered the gold standard in stroke treatment. The analysis also showed that racial minorities were less likely to get the drug than whites.
The results suggest that “women and minorities may be undertreated” for ischemic strokes, according to a report published Wednesday in the journal Neurology.
We can do better - so much better - than this. It also reminds us that stroke patients need advocates, since they generally can't speak for themselves.

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