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Golden Hour for Stroke (GHoSt) – a prospective observational study of biomarkers in acute stroke
Smith, Hazel Luxmore-Brown, Scott Miller, Josh Momin, Sheikh
Smith, Hazel
Luxmore-Brown, Scott
Miller, Josh
Momin, Sheikh
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Affiliation
University Hospitals Birmingham NHS Foundation Trust
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Publication date
2024-09-17
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Abstract
Introduction
Golden Hour study started in 2014 identified early biomarkers in blood and saliva specific to concussion. RECOS and SCRUM studies used these in athletes as part of a suite of tests designed to diagnose concussion pitch-side.
We adapted the Golden Hour study to screen for biomarkers in patients with suspected stroke to identify those who have had a stroke versus those who have mimics, hence the Golden Hour for Stroke (GHoSt) study.
Early recognition of stroke versus mimic could support decision-making ensuring patients are taken to the correct place for treatment more quickly, improving long- and short-term outcomes.
Methods
A Stroke Association Research Grant will allow training of WMAS paramedics in sample collection from 200 patients with suspected stroke. Samples will be brought with patients to the Queen Elizabeth Hospital, Birmingham (part of UHB) for analysis by University of Birmingham (UoB) scientists. Data will be collected and patients consented by Research Nurses and diagnosis of stroke or mimic will be carried out by a Consultant Neurologist. Data analysis will be provided by a UoB Statistician and study oversight by experts. Only by working in this collaborative way can we achieve our goal.
Sampling will be at various intervals between time of 999 call and 1-year. A predefined panel of biomarkers of acute brain injury will be analysed, as well as an exploratory analysis of significantly expressed biomarkers. Outcomes of the study are effectiveness of biomarkers in differentiating between stroke and stroke mimic up to 24 hours from symptom onset and the modified Rankin Scale (mRS) at 3 months.
Results
GHoSt is unique in two perspectives:
1. Facilitation is only possible because of past experience working as a multi-disciplinary team on Golden Hour and other studies.
2. Paramedics do not routinely take blood or saliva samples so this trial will provide them with a new skill.
Conclusion
Our future aim is to use biomarkers to differentiate between haemorrhagic vs ischaemic stroke. This will support decision-making at point of 999 call as well as allow much faster treatment of stroke than is currently possible.
Citation
Smith, H., Luxmore-Brown, S., Miller, J. and Momin, S. (2024) 'Golden Hour for Stroke (GHoSt) – a prospective observational study of biomarkers in acute stroke'. UK Stroke Research Workshop. Keele, 17-18 September.
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Conference Output