The road toward improving the quality and efficiency of stroke prevention and treatment may start in the emergency room, a new study found.
The study revealed that only 55 percent of emergency room patients who were admitted with a type of heart rhythm irregularity known as atrial fibrillation were already taking stoke-preventive medication. The most common form of heart rhythm problem, atrial fibrillation is also a major precursor to stroke.
Providing better preventive therapy and treatment in the emergency room will ultimately reduce the number of future stroke patients and fatalities, said lead study author and Assistant Professor of emergency medicine Phillip Scott.
“The scope of the problem is extraordinarily large,” Scott said in a written statement. “The ER is potentially an efficient place to identify untreated and under-treated atrial fibrillation patients, to inform them of their stroke risk, and to treat them or refer them for treatment.”
Affecting more than 2 million people annually, AF can lead to the accumulation and clotting of blood in the heart’s upper chambers, sharply raising the chance of stroke when clots leave the heart and travel to the brain.
People who have AF are also more prone to cardiovascular diseases like clogged arteries, high blood pressure, or heart failure. Scott said that research has already shown that patients are more apt to accept medical consultation, especially when receiving the information during a medical crisis. For people without health insurance or a regular health care provider, the emergency room also serves as an important source for health care information. Over a six-month period, the study examined adult patients with active AF diagnosed by electro-cardiogram (EKG) in the emergency room.
Out of 78,787 emergency patients treated, a total of 478 individual patients had recurrent non-valvular AF. Sixty-three of the 478 had more than one emergency room visit in the study period. Approximately 25 percent of the 478 had three high-risk factors for stroke, including old age, as the mean patient age was 74.5 years.
The study also recorded an increased AF incidence of 1.1 percent in all emergency room patients, compared to the estimated 0.89 percent of the total American population.
More importantly, the findings show that many people with atrial fibrillation are still getting no stroke-preventive treatment to prevent potential blood clotting. Surprisingly, only about 50 percent of AF patients eligible for blood thinning drugs are actually taking them.
“Current computer models estimate that we could prevent 40,000 strokes each year if we were able to get all eligible patients on appropriate medication,” Scott said.
Susceptibility to AF increases for people over the age of 45, who consequently make up more than 30 percent of all emergency room visits.The University of Michigan Health System, St. Joseph Mercy Hospital and University of Cincinnati Hospital participated in the study.