Golden Hour for Stroke (GHoSt) Study

In the UK alone, stroke accounts for 10% of all deaths and represents a leading cause of adult disability. Stroke has a massive emotional and financial impact on families and places a huge burden on the economy, with a projected cost of £26 billion [1]. One of the challenges to successful stroke treatment is getting patients to hospital before too much irreversible brain damage occurs. Current treatments rely on the rapid diagnosis of stroke type (either ischaemic or haemorrhagic) to direct the appropriate treatment strategy.

In the UK, regional neuroscience ‘hubs’ provide specialist treatment, including invasive clot retrieval or thrombectomy, largely referred from local Hyperacute Stroke Units (HASU) ‘spokes’. At the spoke sites, patients undergo clinical and radiological assessments to determine if they are suitable for transfer to hubs, which may add up to an hour to the treatment pathway. There is an urgent need to identify patients with stroke (including type of stroke) to ensure they are transferred to the right centre and undergo timely treatment.

In the GHoSt study, we aim to study a range of biomarkers in the blood, saliva and urine to assess whether they have an ability to differentiate between ischaemic and haemorrhagic stroke, as well as non-stroke diagnoses (referred to as ‘stroke mimics’), which can be up to 25% of suspected stroke cases [2].

[1] - King D, Wittenberg R, Patel A, Quayyum Z, Berdunov V, Knapp M. The future incidence, prevalence and costs of stroke in the UK. Age Ageing. 2020 Feb 27;49(2):277-282. doi: 10.1093/ageing/afz163. PMID: 31957781; PMCID: PMC7047821.
[2] - Jones AT, O'Connell NK, David AS. Epidemiology of functional stroke mimic patients: a systematic review and meta-analysis. Eur J Neurol. 2020 Jan;27(1):18-26. doi: 10.1111/ene.14069. Epub 2019 Sep 18. PMID: 31448489.

Information coming soon - please check back at a later date.

GHoSt is a multi-centre observational study of biomarkers in acute stroke, based at the following sites:

• University Hospitals Birmingham – clinical site
• University of Birmingham – sponsor, sample processing
• West Midlands Ambulance Service NHS Trust – clinical site

We are currently conducting the pilot phase of the study at the aforementioned sites, following which we will hope to open up to more sites across the UK.