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Consent delay is one of the most common reasons stroke patients in New York State don’t receive tissue plasminogen activator within the first hour (called the “Golden Hour”) of hospital arrival, researchers reported at the American Stroke Association’s International Stroke Conference 2015.

Hospitals target administration of the clot-busting drug within 60 minutes of stroke patients’ arrivals, but miss the goal in more than 50 percent of cases. Researchers studied reasons for tPA delays among 22,620 ischemic stroke patients at 120 New York hospitals.

Delays in tPA administration occurred in 1,145 patients, and reasons for those delays were given in 1,116 patients. Among those they found:

  • Patient/family consent was a factor in delay in 239, or 21 percent of cases.
  • Management of other emergency health conditions caused delays, which occurred in 21 percent of cases.
  • Women were much more likely to experience delay due to patient/family consent than men.
  • Delay due to patient/family consent was more likely on weekends than weekdays.

This state-level study suggests training and tools to improve and shorten the consent process might reduce delays in tPA treatment. Researchers should delve into why these delays occur more with female stroke patients and on weekends, researchers said.