Popa, D.; Iancu, A.; Petrica, A.; Buleu, F.; Williams, C.G.; Sutoi, D.; Trebuian, C.; Tudor, A.; Mederle, O.A. Emergency Department Time Targets for Interhospital Transfer of Patients with Acute Ischemic Stroke. J. Pers. Med.2024, 14, 13.
Popa, D.; Iancu, A.; Petrica, A.; Buleu, F.; Williams, C.G.; Sutoi, D.; Trebuian, C.; Tudor, A.; Mederle, O.A. Emergency Department Time Targets for Interhospital Transfer of Patients with Acute Ischemic Stroke. J. Pers. Med. 2024, 14, 13.
Popa, D.; Iancu, A.; Petrica, A.; Buleu, F.; Williams, C.G.; Sutoi, D.; Trebuian, C.; Tudor, A.; Mederle, O.A. Emergency Department Time Targets for Interhospital Transfer of Patients with Acute Ischemic Stroke. J. Pers. Med.2024, 14, 13.
Popa, D.; Iancu, A.; Petrica, A.; Buleu, F.; Williams, C.G.; Sutoi, D.; Trebuian, C.; Tudor, A.; Mederle, O.A. Emergency Department Time Targets for Interhospital Transfer of Patients with Acute Ischemic Stroke. J. Pers. Med. 2024, 14, 13.
Abstract
Background and objectives: Although intravenous tissue plasminogen activator (rt-PA) has been shown to be effective in the treatment of acute ischemic stroke (AIS) only a small proportion of stroke patients receive this drug. Low administration rate is mainly due to delayed presentation of patients to the emergency department (ED) or lack of a stroke team/unit in most of the hospitals. So, the aim of this study is to analyze ED time targets and the rate of rt-PA intravenous administration after the initial admission of patients with AIS in an ED from a traditional healthcare center (without a neurologist or stroke team/unit). Methods: To analyze which factors, influence administration of rt-PA we split the general sample (n=202) in two groups: group No rt-PA (n=137) and group rt-PA (n=65) based on performing or no intravenous thrombolysis. Results: Analyzing ED time targets for all sample we found that the median onset-to-ED door time was 180 minutes (IQR, 120-217.5 minutes), door-to-physician time was 4 minutes (IQR, 3-7 minutes), door-to-CT time was 52 minutes (IQR, 48-55 minutes), and door-in-door-out time was 61 minutes (IQR, 59-65 minutes). ED time targets such as door-to physician time (p=0.245), door-to-CT time (p=0.219), door-to-door-out time (p=0.24), or NIHSS at admission to Neurology department (p=0.405), or NIHSS after 24 h (p=0.9) did not have a statistically significant effect on administration or no rt-PA treatment in patients included in our study. Only highest Door-to-CT time was statistically significantly correlated with death outcome. Conclusion: In our study, rt-PA administration rate was higher than expected. Statistically significant correlation between ED time targets was found between lower Onset-to-ED door time with administration of rt-PA treatment (p<0.001) and between highest Door-to-CT time and death outcome.
Keywords
emergency department; ED time targets; acute ischemic stroke; rt-PA
Subject
Medicine and Pharmacology, Emergency Medicine
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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