Stroke patients with tight-knit social networks paradoxically had delayed hospital arrival, new study results suggest.
“Closed networks are like echo chambers in which there is a tendency for everyone to agree to watch and wait,” study coauthor Amar Dhand, MD, DPhil, of the Department of Neurology at the Brigham, said in a press release about the results. “A major problem in stroke care is patients’ delayed arrival to the hospital, and we show that this problem is related to the influence of patients’ social networks.”
Researchers for the cross-sectional study, published in Nature Communications, looked at 175 consecutive patients with mild stroke from two centers (Barnes Jewish Hospital in St. Louis, and Brigham and Women’s Hospital in Boston) examined the social networks of 175 stroke patients admitted between 2014 and 2017. The primary outcome was hospital arrival within six hours or beyond six hours of stroke symptom onset (defined as when the patient became aware of symptoms). Patients were given social network surveys at bedside between two and five days following stroke hospitalization. The survey instrument, according to the researchers, was an adaption of the General Social Survey and another national survey of health and social networks.The authors then used multivariate analysis to determined the relationships between the strongest social network variables and delayed hospital arrival.
Paradoxical Result
According to the study results, social network size displayed an inverse relationship with delayed arrival and delayed care. Delayed arrivers tended to have small networks (P<0.0001), were more likely to be black (P=0.0309), and less likely to be given tissue plasminogen activator (P<0.0001). They also had what the authors called higher constraint (P<0.0001), meaning that the tighter knit and redundancy of the smaller social network counter-intuitively constructed the flow of information.
“The difference in treatment frequencies highlights one of the main consequences of arriving late,” the researchers wrote in the study.
The study results remained consistent after adjustment for confounding variables such as age, stroke severity, emergency medical service usage, education, median income, living alone and race. The researchers cited some study limitations, including the patient population being limited mainly to those with mild stroke and the exclusion of non-English speakers or those with severe strokes or aphasia.
Can your network delay you looking for a hospital after a stroke? https://t.co/w6nKuZqcmP
— André C. R. Martins (@Andre_CRMartins) March 15, 2019
I don’t fully understand this, but the concept is fascinating. https://t.co/Iz0b8ju4oZ
— Michael Yeh (@michaelyehmd) March 15, 2019
Fascinating analysis – this deserves more attention as we design public education campaigns for #stroke symptoms https://t.co/Vx7nveEFmk
— Shazam Hussain, MD (@shazamhussain) March 15, 2019
© 2025 Mashup Media, LLC, a Formedics Property. All Rights Reserved.