Vital treatment for stroke care by the Bermuda Hospitals Board has shown marked improvement, with technology playing a key role.

Srinath Meadipudi, the director of the BHB’s Primary Stroke Care Centre, said that since a transatlantic partnership had been established with Johns Hopkins International in 2019, the focus had shifted to hyper-acute stroke care.

He said: “We were dealing mainly with patient education and awareness of access to service as quickly as possible so that we can give the best possible treatment available on the island.”

The BHB sought and attained global accreditation certification, then strengthened its focus on prevention and early treatment of stroke patients in collaboration with Johns Hopkins in Baltimore.

Dr Meadipudi told The Royal Gazette that the BHB was improving its “door-to-needle time”, meaning its speed on beginning clot-busting treatment for a stroke — leading to better outcomes.

He added: “I think for the first time we are seeing good improvements because we have made some changes within our protocols and pathways and how we actually treat the patients when they arrive in our emergency department.”

Dr Meadipudi said the number of patients accessing stroke treatment at King Edward VII Memorial Hospital was rising “year by year”.

Over the past 24 months, 446 patients were treated for strokes at the hospital.

Patients experienced both ischemic stroke, caused by a blockage in an artery, and haemorrhagic stroke — which is caused by bleeding.

Dr Meadipudi said 71 per cent of the strokes recorded by the BHB over the two year period were ischemic strokes, while 8 per cent were haemorrhagic.

The rest were mini-strokes, temporary blockages often referred to as “transient ischemic attack”.

Almost 100 of the patients received the clot-busting medication, which Dr Meadipudi called “a good improvement from what we were seeing before”.

He added: “As we know, the earlier the better — there are less complications.

“We haven’t had any major complications as a result of giving this medication.”

Victor Urrutia, the medical director of stroke services at Johns Hopkins International, said the clot-busting medication effectively dissolved blockages obstructing an artery.

When a stroke patient visits KEMH, a combination of factors such as their medical history, their blood count and imagery from previous treatment are considered before the treatment is administered.

Dr Meadipudi said 52 per cent of the 446 patients examined by staff at KEMH were female.

The BHB figures indicate that 22.4 per cent of strokes came from patients in the 60 to 69-year-old bracket.

He said 26.5 per cent were logged for patients aged 70 to 79, 25.6 per cent in ages 80 to 89 and 7 per cent for those aged 90 and above.

He said 1.1 per cent of stroke patients were under 40, 3.6 per cent in the 40 to 49 age range while 13.9 per cent were recorded in people aged 50 to 59.

He added: “The majority of strokes we see are for people 50 and above, up to about 90 years old.”

Dr Meadipudi said the BHB and Johns Hopkins were looking to deliver advanced treatment to stroke patients at the Maryland hospital.

To advance treatment at KEMH, the BHB added specialised software to its CT and MRI scanners, which Dr Meadipudi said helped the Johns Hopkins neurologist team to assess and provide requisite advice.

The partnership started in 2019 when a team from Johns Hopkins International visited KEMH to assess the stroke programme and made recommendations.

The Johns Hopkins team established protocols with the BHB and trained physicians, nurses and therapists.

The programme was launched in July that year, with a telemedicine element rolled out in December 2020.

As part of treatment, John Hopkins physicians evaluate MRI and CT images from patients, received instantly from KEMH, and provide recommendations.

Dr Urrutia said the new methods had delivered “very good results”.

Dr Meadipudi said the BHB continued stroke awareness across the island.

He said: “We are exploring every opportunity we have within the community as well as using the media and other resources to promote stroke prevention.”

Dr Urrutia urged residents to exercise regularly — approximately 150 minutes weekly — stick to a healthy diet and control medical issues such as diabetes, as well as checking their blood pressure regularly.

Dr Meadipudi said strokes could be “reversed” if a patient reached hospital as quickly as possible.

He added: “I would request the public to access the services at the hospital without delay, even if the symptoms are resolved at home, because that is a warning sign. That means you are at risk of having a major stroke very soon.”

A spokeswoman said a patient who visited the hospital exhibiting stroke symptoms would get immediate priority.