Every 10 minutes saved in accessing thrombectomy gives patient an extra 40 days of healthy living

Every minute that thrombectomy (mechanical removal of the clot that has caused the stroke) for a stroke patient who has suffered an ischaemic stroke is delayed, decreases both the quality and length of their life, new research has found.

The study, which was presented at a major international medical conference in the US recently, revealed that every 10 minutes of delayed care reduced a patient’s ability to live disability free by about 40 days.

Stroke occurs when a blood clot moves from somewhere else in the body to the head and blocks off a major blood vessel in the brain. The vast majority or 85 per cent of strokes are caused in this way. Not all blood clots are the same. Some clots are easily dissolved by clot dissolving drugs, but many clots are not. More recently, a new surgical procedure called thrombectomy has been developed, in which the clot is mechanically removed.

The study, which included data from Irish patients, also calculated the costs of delaying treatment to the healthcare system and society overall, which includes losses of productivity and informal care given by family members.

According to the findings, a time delay of 10 minutes reduced the cost savings provided by thrombectomy to the healthcare system and society overall by approximately $10,000 or EUR8,500.

“This study shows that time delays can have a significant impact on a patient and society,” said Dr Wolfgang Kunz, lead author of the study and radiology resident at Ludwig-Maximilians-University in Munich, Germany.

“Significant time delays of on average 2 hours could be prevented in triage if EMS send patients with severe signs of stroke directly to a comprehensive or Level 1 stroke centre that provides EVT instead of the closest primary stroke centre,” he said.

Other recommendations include improving in-hospital workflow by notifying the hospital in advance to have the full stroke team ready when the patient arrives in the emergency room and by distributing tasks among a coordinated stroke team.

Dr John Thornton, Consultant Interventional neuroradiologist at Beaumont Hospital in Dublin and the Director of the National Thrombectomy Service in Ireland, said the study based on a population, which includes patients from Ireland, gives another important description of the value of speed in treating acute stroke victims.

“The effects a 10 minute delay in treatment is to reduce the cost savings by $10,000 and highlights the value of the treatment in the first place, saving the state a large amount of money for each patient who does not end up with a high level of dependency on carers at home or in hospital,” Dr Thornton said.

“Every 10 minutes saved results on average in an extra 40 days of healthy living. Its an incredible treatment really,” he added.

(Lifetime Quality of Life and Cost Consequences of Treatment Delays in Endovascular Thrombectomy for Stroke Based on HERMES Data, was released at the 15th Annual Meeting of the Society of NeuroInterventional Surgery, which took place in San Francisco in the US from the 23 to 26 July 2018.)