The Particulars: Guidelines recommend that tPA be administered intravenously within 3 to 4 hours of the onset of stroke symptoms to reduce disability. They also recommend that endovascular therapy be utilized when appropriate to reopen clogged arteries. Little is known about the percentage of patients who receive these recommended treatments.

Data Breakdown: Investigators reviewed 370,000 Medicare stroke claims from 2011. The study team found that 81% of patients had access (within an hour’s drive) to a hospital capable of administering tPA whereas 61% had access to a primary stroke center and 56% had access to a hospital capable of performing endovascular therapy. However, only 4% of patients received tPA within 3 to 4 hours of symptom onset, and less than 1% underwent endovascular therapy.

Take Home Pearl: Many patients appear to live within an hour’s drive of a hospital equipped to treat acute stroke, but very few receive guideline-recommended treatments for it.