Background
Effective and timely treatment for acute stroke demands concerted multidisciplinary efforts for a hospital to provide treatment on a 24-hour basis. It poses great challenges to the private sector which must assure price transparency.
Method
The Acute Stroke Assessment Program (ASAP) is activated by attending RMO in the 24-hour Out-patient Department for potential candidate for thrombolysis. The study is a retrospective review of patients recorded in the ASAP registry as of 31 December 2023.
Results
From 1 March 2016 through 31 December 2023, 185 patients were enrolled in the registry. The final diagnosis is acute ischaemic stroke in 71 patients (38.4%), transient ischemic stroke (TIA) in 35 patients (18.9%), acute haemorrhagic stroke in 24 patients (13%), and non-stroke disorder in 55 patients (29.7%). The diagnoses in all patients made by the attending neurologists before admission are verified in this retrospective review. 21 patients (29.6% of all acute ischaemic stroke) were eligible for thrombolytic therapy and received treatment. The door-to-needle time ranged from 46 to 133 minutes. Among the 50 patients (70.4% of all acute ischemic stroke) did not receive thrombolytic therapy, 21 (42%) had pre-hospital delay (arrived at the hospital over 3 hours from symptom onset) leading to ineligibility to thrombolytic therapy.
Conclusion
The study demonstrates a protocol-based multidisciplinary acute stroke care in local private hospitals is feasible, safe and effective to provide state-of-the-art treatments to acute stroke patients. Further acute stroke education to raise awareness in the general public is indeed of high importance to reduce barrier to timely management.