Intravenous thrombolysis for ischaemic stroke: short delays and high community-based treatment rates after organisational changes in a previously inexperienced centre. Issue 5 (22nd April 2009)

• Record Type: Journal Article
• Authors: Tveiten, A; Mygland, Å; Ljøstad, U; Thomassen, L
• Is Part Of: Emergency medicine journal. Volume 26:Issue 5(2009)
• Page Start: 324
• Page End: 326
• Publication Date: 2009-04-22
• Subjects: Emergency medicine -- Periodicals; 616.02505
• DOI: 10.1136/emj.2008.063610
• Languages: English
• ISSNs: 1472-0205

Abstract

Abstract : Aim: To evaluate hospital delays in thrombolytic treatment before and after organisational changes and community-based treatment rates in a previously inexperienced centre. Methods: The delays before and after organisational changes made in 2006 were compared using a prospective treatment database. In a 6-month period in 2007, a community-based search was performed for all hospitalisations for ischaemic stroke. The number of patients admitted within the 0–3 h time window and the proportion treated with tissue plasminogen activator were analysed. Results: The number of treatments increased fourfold from 2005 to 2007 with a significant reduction in mean door-to-needle time from 60 min to 38 min (p = 0.002). In the community-based series, 14/137 patients (10%) hospitalised with ischaemic stroke and 13/32 patients (41%) admitted in the 0–3 h window were treated. Conclusions: An inexperienced stroke centre can rapidly implement the necessary logistics to deliver thrombolysis to a large proportion of patients with acute stroke with short hospital delays. Important factors are probably prenotification of a team and the initiation of thrombolytic treatment in the emergency room.