By skyforbes Sheth’s recent publication is the result of a collaboration with the American Heart Association Get With The Guidelines® stroke registry, one of the largest stroke registries in the world. Within the registry, his team identified people who had suffered a brain hemorrhage, who were on blood thinners at the time of their hemorrhage, and who had received anticoagulant reversal agents. Then, for this cohort, they observed the time duration between the patients’ arrival to the emergency department and delivery of treatment. “There was a large distribution there,” says Sheth. “Some received the reversal agent quickly, while for others it was quite slow.”
Their analyses revealed that those who were treated quickly with a reversal agent showed the best outcomes. Patients who were treated within an hour of arrival to the emergency department had the greatest likelihood of survival. “There are popular phrases we have in neurology like, ‘time is brain,’ and ‘every minute counts,’” says Sheth. “These results are in line with these phrases, but for brain hemorrhages, they are being verified for the first time.”
The team also found several factors that were significantly correlated with shorter wait times. For example, white patients faced significantly shorter wait times than Black patients. “We not only have the opportunity to improve overall survival for brain hemorrhages, but also for attenuating health disparities,” says Sheth.
The study is evidence that brain hemorrhages are a time-sensitive emergency in which every minute counts. “Before, we didn’t know time was important, so clinicians weren’t making the same mad rush that they were for clotting strokes,” says Sheth. “Now, we can begin driving quality improvement efforts for treating brain hemorrhages more quickly.”
Sheth’s team is continuing to work with the American Heart Association to conduct further analyses. They hope to learn more about the factors underlying why some patients wait longer for treatment, and also develop and roll out initiatives for helping patients get the care they need more rapidly.