Telestroke Networks Mitigate Racial and Socioeconomic Disparities in Stroke Care

A large-scale telestroke network in Pennsylvania and a university medical center in Rhode Island have shown promising results in addressing racial and socioeconomic disparities in stroke treatment and recovery. Researchers presented three studies at the Society of NeuroInterventional Surgery's 22nd Annual Meeting, highlighting the impact of telestroke care on patients across racial, gender, and socioeconomic lines. The studies suggest that telestroke treatment can mitigate longstanding racial and gender disparities in stroke care, but emphasize the need for further research into long-term recovery and rehabilitation disparities.

Key Takeaways:

• The studies reviewed medical records for over 10,000 patients with suspected ischemic stroke in a large telestroke network and a university medical center.
• Men and women were equally likely to receive thrombectomy, but women were less likely to receive tissue plasminogen activator (tPA), with only 13% of women receiving tPA compared to 15% of men.
• Telestroke networks can help reduce racial disparities in acute stroke care, particularly in the administration of tPA and mechanical thrombectomy.
• Post-stroke rehabilitation outcomes differed between racial groups, emphasizing the need for further research into long-term recovery and rehabilitation disparities.
• Neighborhood disadvantage was found to affect patients' time to stroke treatment, with patients from more disadvantaged neighborhoods having a longer wait for thrombectomy and worse health after stroke.
• Field triage and immediate routing to a comprehensive stroke center were found to improve outcomes after thrombectomy, particularly for patients from disadvantaged neighborhoods.
• The studies' authors emphasize the need to further investigate issues of gender and racial disparities in stroke treatment and recovery to ensure optimal outcomes for all patients.

Statistics:

• 7,947 patients with suspected ischemic stroke were reviewed in the first study.
• 2,952 white patients and 1,122 Black patients were reviewed in the second study.
• 13% of women received tissue plasminogen activator (tPA) compared to 15% of men.
• Patients from more disadvantaged neighborhoods had a longer wait for thrombectomy and worse health after stroke.
• Field triage was used for half of the patients studied, leading to better outcomes after thrombectomy.
• The Area Deprivation Index tool was used to categorize patients' socioeconomic status.

Sources:

• Society of NeuroInterventional Surgery (SNIS)
• Thomas Jefferson University Hospital in Philadelphia
• Brown University
• van Comm, LLC (public relations firm)