Bridging the Distance for Ischaemic Stroke Treatment in Regional Australia: A Retrospective Cohort Study.
Stephanie Caldwell, Bronwyn Griffin, Ramon Navarro and 3 others
PMID 42011807WHAT IT FOUND
Only 13% of 305 regional stroke patients received thrombolysis and 19% underwent clot retrieval.
Transferred patients had a median 401 minute onset to centre time. It describes delays, not tested treatments.
Key findings
01Of 305 analysed ischaemic stroke patients, 13% received thrombolysis and 19% underwent endovascular clot retrieval.
02For transferred patients, median onset to comprehensive stroke centre time was 401 minutes, and for patients with a single transfer median door-in-door-out time was 189 minutes.
03First Nations patients were younger than non-Indigenous patients, with median ages of 51 and 74 years.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was retrospective and single centre, so it describes one regional service rather than all regional stroke care. Many patients who did not reach the comprehensive stroke centre were not counted, so the rates may not reflect the whole region. Missing data were common, especially functional outcomes, because they were not routinely documented. Remoteness was assigned by postcode, which may not match where the patient was when stroke started. Stroke cause was often unknown and sometimes inferred from notes, tests, risk factors, and stroke location. The study recorded risk factor diagnoses or prescriptions, but not whether those risk factors were controlled or effectively managed. Length of stay may include time spent awaiting nursing home placement or palliation rather than acute care. Some onset and transfer times were missing or inaccurate and were excluded from time analyses. No intervention was tested, so the study cannot show that any care pathway improved outcomes.
Declared interests
The authors declared no conflicts of interest. Funding was from a SERTA Research Seed Fellowship, and Townsville Hospital and Health Service was named as funder.
The easy way to misread this
Do not read the 89% successful recanalisation rate as proof that this service improves outcomes. This was a descriptive retrospective cohort without a tested intervention, and patients who did not reach the centre were not counted.