The paradox in stroke treatment

Closer social ties contributed to the delay in the admission of patients to the hospital

Lina Medvedeva, XX2 century

Examples of social ties are (a) close ties with close relatives: son, sister, mother; (b) more scattered social ties with close relatives, friends, neighbors, colleagues. Figure from the article by Dhand et al. Social networks and risk of delayed hospital arrival after acute stroke, published in the journal Nature Communications.

The study showed that close social ties between family members limit the flow of information and delay the hospitalization of those who need vital care.

Recently developed treatment strategies can minimize the damage to the body in stroke and transform (in most cases) this event is insignificant, with the prospect of a quick recovery. But these treatments are highly time-dependent, and a delay in seeking medical help may make them unavailable.

Researchers from Brigham and Women's Hospital (Brigham And Women's Hospital) studied how social connections can affect the delay in hospitalization of patients with stroke symptoms. Paradoxically, they found that patients with closer social ties, including ties with family members, spouses, are more likely to postpone seeking help at the hospital, and patients with a disparate network of acquaintances seek help faster.

"Closed networks are like an echo chamber where everyone agrees to watch and wait," says Amar Dhand. – The main problem in the treatment of stroke is the delay in the arrival of patients to the hospital, and we have shown that this problem is related to the influence of the patient's social ties."

Dhend and his colleagues interviewed 175 patients within 5 days after a stroke. Information about social connections was collected from each participant of the study and schematics of these connections were drawn up. The group focused on patients with milder symptoms because it is this group that is at higher risk of delaying seeking help, and also because people from this group were able to participate in the study during hospitalization.

The researchers found that those who arrived at the hospital later had fewer connections, but they were stronger than those who arrived quickly. This confirms the paradoxical role of a person's social environment in a situation when he needs an ambulance. The authors concluded that the transition from mass education about stroke symptoms to a more targeted approach can help reduce the time after which the patient seeks help. Identifying at-risk patients with a small number of close connections before a stroke and spreading information among them about the symptoms and pitfalls of communication with loved ones, as well as helping to develop an action plan that may include calling a pre-selected friend, can contribute to greater preparedness for stroke and better treatment results.

This study was limited to patients who had a mild stroke, but it remains to be seen whether social connections play an equally large role in delaying hospitalization in moderate and severe strokes. The survey did not include people who do not speak English, as well as patients with aphasia. The authors note the need for further research.

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