ISC 2024 | Rural versus urban hospital performance in ischemic stroke thrombolysis

Shumei Man, MD, PhD, Cleveland Clinic, Cleveland, OH, discusses rural versus urban hospital performances in ischemic stroke thrombolysis care metrics. Studies have revealed a 30% higher incidence of stroke and 30% higher stroke mortality in patients living in rural areas compared to those living in urban areas. Dr Man’s study aimed to shed light on whether this disparity is due to delayed hospital arrival or in-hospital care. When comparing thrombolysis rates among patients arriving in the 4.5-hour time window, rural hospitals provided less thrombolysis and had longer door-to-needle times. When looking specifically at stroke centers, rural stroke centers performed worse than urban stroke centers with regards to thrombolysis rates and timing. Overall, these data suggest that in-hospital factors are impacting the differences in care received by rural residents, not just pre-hospital delays. This interview took place during the International Stroke Conference 2024 in Phoenix, AZ.

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