0 71

Cited 0 times in

Delayed Intravenous Thrombolysis in Patients with Minor Stroke

Authors
 Yoo J.  ;  Sohn S.-I.  ;  Kim J.  ;  Ahn S.H.  ;  Lee K.  ;  Baek J.-H.  ;  Kim K.  ;  Hong J.-H.  ;  Koo J.  ;  Kim Y.D.  ;  Kwak J.  ;  Nam H.S.  ;  Heo J.H. 
Citation
 Cerebrovascular Diseases, Vol.46(1-2) : 52-58, 2018 
Journal Title
 Cerebrovascular Diseases 
ISSN
 1015-9770 
Issue Date
2018
Keywords
Acute stroke therapy ; Emergency department ; Ischemic stroke ; Quality assessment ; Thrombolysis ; Tissue plasminogen activator
Abstract
BACKGROUND: The actions and responses of the hospital personnel during acute stroke care in the emergency department (ED) may differ according to the severity of a patient's stroke symptoms. We investigated whether the time from arrival at ED to various care steps differed between patients with minor and non-minor stroke who were treated with intravenous tissue plasminogen activator (IV tPA). METHODS: We included consecutive patients who received IV tPA during a 1.5 year-period in 5 hospitals. Minor stroke was defined as a National Institutes of Health Stroke Scale (NIHSS) score < 5. We compared various intervals from arrival at the ED to treatment between patients with minor stroke and those with non-minor stroke (NIHSS score ≥5). Delayed treatment was defined as a door-to-needle time > 40 min. RESULTS: During the study period, 356 patients received IV tPA treatment. The median door-to-needle time was significantly longer in the minor stroke group than it was in the non-minor stroke group (43 min [interquartile range [IQR] 35.5-55.5] vs. 37 min [IQR 30-46], p < 0.001). The minor stroke group had a significantly longer door-to-notification time (7 min [IQR 4.5-12] vs. 5 min [IQR 3-8], p < 0.001) and door-to-imaging time (20 min [IQR 15-26.5] vs. 16 min [IQR 11-21], p < 0.001) than did the non-minor stroke group. However, the imaging-to-needle time was not different between the groups. Multivariable analyses revealed that minor stroke was associated with delayed treatment (OR 2.54 [95% CI 1.52-4.30], p = 0.001). CONCLUSIONS: Our findings show that the door-to-needle time was longer in patients with minor stroke than it was in those with non-minor stroke, mainly owing to delayed action in the initial steps of neurology notification and imaging. Our findings suggest that some quality improvement initiatives are necessary for patients with suspected stroke with minor symptoms.
Full Text
https://www.karger.com/Article/FullText/492123
DOI
10.1159/000492123
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
김경섭(Kim, Kyoung Sub)
김영대(Kim, Young Dae) ORCID logo https://orcid.org/0000-0001-5750-2616
남효석(Nam, Hyo Suk) ORCID logo https://orcid.org/0000-0002-4415-3995
유준상(Yoo, Joon Sang)
허지회(Heo, Ji Hoe) ORCID logo https://orcid.org/0000-0001-9898-3321
Export
RIS (EndNote)
XLS (Excel)
XML
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163196
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse