Journal
NEUROLOGIST
Volume 27, Issue 2, Pages 61-64Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/NRL.0000000000000372
Keywords
rtPA; door to needle; acute ischemic stroke; Egypt; thrombolysis
Categories
Ask authors/readers for more resources
This study shares the experience of changing hospital strategies to achieve rapid thrombolysis in acute ischemic stroke patients. Applying certain logistic strategies significantly reduced door to needle time and improved clinical outcomes for patients.
Background: The purpose of this study is to share our experience in changing hospital strategies to achieve rapid thrombolysis in acute ischemic stroke (AIS) patients in 2 university stroke centers. Rapid reperfusion by shortening door to needle time (DTN) reduces morbidity and mortality for patients with AIS. Our aim is to evaluate the effect of applying certain logistic strategies to reduce DTN for thrombolysis and its impact on clinical outcome. Methods: In this retrospective registry-based observational study from the SITS-ISTR Dataset, we studied AIS patients admitted to 2 stroke centers in Ain Shams University over 3 successive years from 2016 till 2018. We analyzed change of DTN and outcome at 3 months by modified Rankin scale over these 3 years. Results: By the end of the 3 year period there was a 6.1% increase in number of patients receiving thrombolysis. There was a significant decrease of median DTN by 41%, and increase in percentage of patients receiving recombinant tissue plasminogen activator within a shorter DTN. Also, the number of patients with a favorable outcome (modified Rankin scale <= 2) increased by 23.3%. There was insignificant difference regarding mortality rate. Conclusion: Applying a goal-directed corrective strategy to improve quality of service can, in a short time, reduce DTN and improve patient outcome.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available