THEY say "time is brain" when it comes to a stroke, and now Hunter research and innovation is buying precious time for residents of rural NSW.
Professor Neil Spratt, the director of acute stroke services at the John Hunter Hospital, said their pilot project that had been designed to give rural stroke patients faster access to expert advice and treatment had been so effective it was now being rolled out across the state.
"What it means is, wherever you are in NSW, you will have access to the best therapies if you have a stroke," Professor Spratt said.
The world-first "telestroke" pilot study had begun in hospitals in northern NSW, and the results have since earned Professor Pratt and his team a nod in the 2020 HNE Health Excellence Awards.
"We set up a system whereby rural patients can get assessed by an expert stroke neurologist - basically straight away - when they come in with a stroke," he said.
"They get advanced imaging done, and then have treatment decisions made regarding some of the acute therapies - the therapies we need to give in the very early time window after stroke. Some of those patients receive medication, and some get flown down to John Hunter to have a clot-retrieval procedure.
"Stroke is caused when you get a blockage of an artery in the brain, and with this procedure, you pull the blockage out if it doesn't look as though it will dissolve with medication. These two procedures are among the most effective therapies in medicine."
Professor Spratt said the clot-retrieval procedure was used for people who suffered "big, bad, disabling strokes".
"Without the procedure, maybe about 15 per cent would be independent - or able to look after themselves - at three months," he said. "But with the procedure, it's close to 50 per cent. It is still not everyone, but some people are literally cured - they are completely better.
"It triples your chances of doing well if you've had one of these bad strokes."
Professor Spratt said the imaging technology used in the rural hospitals was "simple" - a software upgrade to a CT scanner. But it allowed specialists in Newcastle and Gosford to examine the scans within minutes, and advise on the best treatment option.
"Since we first started, we have assessed well over 1000 patients, treated well over 100 with the intravenous medication, and transferred 76 down here to have this clot retrieval procedure.
"Almost all of those patients wouldn't have received that treatment previously."
Professor Spratt said 10 per cent of the "worst strokes" accounted for about 50 per cent of associated disability.
"It's disability in particular that we are concerned about with stroke, because it can be so incapacitating and ruin people's lives," he said.
"Something we are already seeing since we started doing these procedures routinely is that there is less people needing to stay a long time in hospital, less people needing to go to rehabilitation, and the ones who do go to rehabilitation don't spend as long in there. There is also less people then needing to go to nursing homes."
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