Minorities, women, seniors on Medicare, rural residents less likely to be diagnosed in time for tPA
THURSDAY, Feb. 23, 2017 (HealthDay News) — Blacks, Hispanics, women, seniors on Medicare, and patients in rural areas are less likely to be treated with tissue plasminogen activator (tPA) after stroke, according to research presented at the annual American Stroke Association’s International Stroke Conference, held from Feb. 22 to 24 in Houston.
Tracy Madsen, M.D., an assistant professor of emergency medicine at Brown University’s Warren Alpert Medical School in Providence, R.I., and colleagues reviewed the records of 563,087 patients with ischemic stroke between 2005 and 2011. Across the entire period of time, only 3.8 percent of total patients received tPA.
The team found certain types of patients were less likely to receive tPA: blacks were 38 percent less likely than whites; Hispanics were 25 percent less likely than whites; women were 6 percent less likely than men; patients with private insurance were 29 percent more likely to receive tPA compared to those on Medicare; and patients living in the southeastern United States were 31 percent less likely than those living elsewhere to receive tPA.
Stroke patients treated at a large urban hospital, a teaching hospital, or a designated stroke center had a better chance of prompt treatment that would include tPA. “They are much more likely to have stroke protocols in place that make things happen faster,” Madsen told HealthDay. “Patients get their brain scans faster. Patients are evaluated more quickly when they arrive at the door. It really is treated as an emergency.” Patients also were more likely to get tPA if they were treated at a hospital participating in a program sponsored by the American Stroke Association that focuses on faster delivery of treatment to stroke patients, Madsen said.
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