The impact of response times on effect of thrombolysis and other research

Waiting for thrombo(lysis)One of the many terrifying aspects of our healthcare system that we seem to be quietly accepting of is ambulance response times. In England in December 2023 the median response time for a category 2 emergency call—which includes stroke calls—was 45 minutes, compared with a target of 18 minutes. Of the callouts, 10% had a wait time of 1 hour 40 minutes or longer. For those unlucky people who are waiting this long and have had a stroke amenable to intravenous thrombolysis (IVT) followed by thrombectomy, the time for any added benefit from IVT and thrombectomy versus thrombectomy alone is nearly up before the ambulance arrives, according to a new meta-analysis. The study looked at individual patient data from six randomised control trials, assessing levels of disability at 90 days. Benefits of IVT plus thrombectomy versus thrombectomy alone were greater the sooner after symptom onset that treatment was…
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