Stroke Laterality Bias in the Management of Acute Ischemic Stroke

Abstract

Background: Little is known of the impact of stroke laterality on the management process and outcome of patients with acute ischemic stroke (AIS).

Methods: Consecutive patients admitted to a general hospital over 1 year with supratentorial AIS were eligible for inclusion in the study. Baseline characteristics and risk factors, delays in hospital admission, imaging, intrahospital transfer to an acute stoke unit, stroke severity and classification, length of hospital admission, as well as 10-year mortality were measured and compared among right and left hemisphere AIS patients.

Results: There were 141 patients (77 men, 64 women; median age 73 [interquartile range 63-79] years), There were 71 patients with left hemisphere AIS and 70 with right hemisphere AIS. Delays to hospital admission from stroke onset to neuroimaging were similar among right and left hemisphere AIS patients. Delay in transfer to an acute stroke unit (ASU) following hospital admission was on average 14 hours more for right hemisphere compared to left hemisphere AIS patients (P = .01). Laterality was not associated with any difference in 10-year survival.

Conclusions: Patients with mild and nondominant AIS merit particular attention to minimize their intrahospital transfer time to an ASU.

Keywords: Stroke laterality; acute ischemic stroke; nondominant stroke; stroke unit.