Emergency Department Time Targets for Interhospital Transfer of Patients with Acute Ischemic Stroke.

Autor:	Popa D; Department of Surgery, Emergency Discipline, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania., Iancu A; Department of Radiology, 'Victor Babes' University of Medicine and Pharmacy, E. Murgu Square no. 2, 300041 Timisoara, Romania., Petrica A; Department of Surgery, Emergency Discipline, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania., Buleu F; Department of Cardiology, 'Victor Babes' University of Medicine and Pharmacy, E. Murgu Square no. 2, 300041 Timisoara, Romania., Williams CG; Emergency Municipal Clinical Hospital, 300254 Timisoara, Romania., Sutoi D; Department of Surgery, Emergency Discipline, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania., Trebuian C; Department of Surgery, Emergency Discipline, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania., Tudor A; Department of Functional Sciences, 'Victor Babes' University of Medicine and Pharmacy, E. Murgu Square no. 2, 300041 Timisoara, Romania., Mederle OA; Department of Surgery, Emergency Discipline, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania.; Department of Surgery, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, 'Victor Babes' University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Jazyk:	angličtina
Zdroj:	Journal of personalized medicine [J Pers Med] 2023 Dec 21; Vol. 14 (1). Date of Electronic Publication: 2023 Dec 21.
DOI:	10.3390/jpm14010013
Abstrakt:	Background and objectives : Although the 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. The low administration rate is mainly due to the delayed presentation of patients to the emergency department (ED) or the lack of a stroke team/unit in most of the hospitals. Thus, 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 the administration of rt-PA, we split the general sample ( n = 202) into two groups: group No rt-PA ( n = 137) and group rt-PA ( n = 65). This is based on the performing or no intravenous thrombolysis. Results: Analyzing ED time targets for all samples, we found that the median onset-to-ED door time was 180 min (IQR, 120-217.5 min), door-to-physician time was 4 min (IQR, 3-7 min), door-to-CT time was 52 min (IQR, 48-55 min), and door-in-door-out time was 61 min (IQR, 59-65 min). ED time targets such as door-to-physician time ( p = 0.245), door-to-CT time ( p = 0.219), door-in-door-out time ( p = 0.24), NIHSS at admission to the Neurology department ( p = 0.405), or NIHSS after 24 h ( p = 0.9) did not have a statistically significant effect on the administration or no rt-PA treatment in patients included in our study. Only the highest door-to-CT time was statistically significantly correlated with the death outcome. Conclusion: In our study, the iv rt-PA administration rate was 32.18%. A statistically significant correlation between the highest door-to-CT time and death outcome was found. Competing Interests: The authors declare no conflicts of interest.
Databáze:	MEDLINE
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