Stroke is a well-known complication of acute medical or surgical illnesses. Prior work has shown that patients with stroke occurring in the hospital are more likely to encounter delays in diagnosis, have gaps in care, and experience worse outcomes compared with patients with stroke occurring out of the hospital.1,2 Delay in the recognition of symptoms of stroke is particularly relevant for extremely short-term revascularization therapies, which was previously limited to a relatively narrow time window for treatment with intravenous thrombolysis. Patients with in-hospital stroke may be more likely than patients with community-onset stroke to have contraindications to systemic thrombolysis because they may be recovering from surgery, experiencing systemic bleeding, admitted after major trauma, or have sundry other reasons. Contemporary hyperacute stroke care has shifted from a time-based focus to an emphasis on tissue-based assessment using neurovascular imaging to identify patients who may benefit from revascularization with thrombolysis or endovascular thrombectomy.3-7 It is therefore highly relevant to reexamine the quality of care and outcomes after short-term reperfusion treatment in patients with in-hospital stroke.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Yu AYX, Hill MD. In-Hospital Acute Strokes—Opportunities to Optimize Care and Improve Outcomes. JAMA Neurol. 2020;77(12):1482–1483. doi:10.1001/jamaneurol.2020.3368
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: