• Posted September 12, 2024

Black Stroke Patients More Likely to Arrive Late at Hospital, Without Prior ER Notification

Black stroke victims are arriving at emergency rooms much later than white patients, greatly increasing their risk of death or lifelong disability, a new study finds.

Every second counts when it comes to treating a stroke, experts say.

Any moment’s delay allows for more brain damage to occur, and patients could arrive too late for doctors to provide advanced stroke treatments like clot-busting medications or clot-removal surgery.

But it takes Black patients about 28 minutes longer to be brought to a hospital for emergency care after developing stroke symptoms, according to results published recently in the journal Circulation.

“Unfortunately, we are seeing that disparities in the care of acute stroke begin before the patient even reaches the hospital,” said lead researcher Dr. Regina Royan, a clinical assistant professor of emergency medicine at the University of Michigan Medical School. “We need to devote greater attention to eliminating these differences in care from the minute a patient calls 911.“

Additionally, emergency medical workers are 20% less likely to alert a hospital ahead of a Black stroke patient’s arrival, compared to a white patient, researchers found. Hispanic and Asian stroke patient also had lower odds that paramedics would call ahead.

Making sure ERs are ready to receive a stroke patient can improve treatment time, further boosting their odds of survival.

“We know that an EMS notification of stroke leads to more timely and high-quality care when a patient arrives at the emergency department, yet these gaps in prehospital notification exist and may be getting worse,” said researcher Dr. Brian Stamm, a clinical instructor of neurology at the University of Michigan.

For the new study, researchers evaluated American Heart Association data for more than 600,000 patients treated for stroke between 2015 through 2019.

About the same percentage of Black and White patients called 911 for paramedic care and transport during a stroke, results show.

But it took longer for EMS to transport Black patients to an ER, researchers found.

Patients that live in more deprived counties -- with more poverty, lower education and less access to transportation -- also took longer to arrive at an ER or have the hospital notified in advance.

These delays in transport might be partly due to systemic problems in EMS care, researchers said.

“In rural areas, an entire county may be serviced by a single municipal EMS agency,” said senior researcher Dr. Tracy Madsen, vice chair of research in emergency medicine at Brown University.

“Future national studies could evaluate the role that different EMS agencies play in prehospital stroke performance,” Madsen added in a American Heart Association news release.

More information

The U.S.Centers for Disease Control and Prevention has more about stroke.

SOURCE: American Heart Association, news release, Sept. 10, 2024