Direct admission to stroke centers reduces treatment delay and improves clinical outcome after intravenous thrombolysis

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
Dae-Hyun KimJae-Kwan Cha

Abstract

We aimed to examine whether direct access to hospitals offering intravenous thrombolysis is associated with functional outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis. We enrolled patients who received intravenous thrombolysis within 4.5hours of symptom onset using a prospective multicenter registry database. Patients referred directly from the field to organized stroke centers were compared with those who were transferred from non-thrombolysis-capable hospitals in terms of clinical outcomes at 90days after intravenous recombinant tissue plasminogen activator treatment. We also investigated onset-to-door time and onset-to-needle time according to admission mode. A total of 820 patients (mean age of 67.3years and median National Institutes of Health Stroke Scale score of 9) were enrolled. Seventeen percent of patients with AIS who received intravenous thrombolytic therapy at 12 hospitals (n=142) were transferred from other hospitals. The direct admission group had a shorter median onset-to-admission time (63 versus 121minutes, P<0.001) and onset-to-needle time (110 versus 161minutes, P<0.001) as compared with the indirect admission group. Direct admission was associated with a good outcome w...Continue Reading

References

Dec 14, 1995·The New England Journal of Medicine·UNKNOWN National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group
Aug 26, 1998·Neurology·S C MenonL B Morgenstern
Nov 4, 2000·Stroke; a Journal of Cerebral Circulation·D L MorrisS Hamilton
Jan 11, 2000·Stroke; a Journal of Cerebral Circulation·K M ChapmanP A Teal
Mar 16, 2004·Lancet·Werner HackeUNKNOWN NINDS rt-PA Study Group Investigators
Feb 4, 2005·Stroke; a Journal of Cerebral Circulation·Lee H SchwammUNKNOWN American Stroke Association's Task Force on the Development of Stroke Systems
Sep 29, 2007·Stroke; a Journal of Cerebral Circulation·Joe E AckerUNKNOWN American Stroke Association Expert Panel on Emergency Medical Services Systems, Stroke Council
Jul 24, 2008·Cerebrovascular Diseases·Marc RiboJose Alvarez-Sabin
Jun 5, 2010·Stroke; a Journal of Cerebral Circulation·Jeffrey L SaverUNKNOWN GWTG-Stroke Steering Committee and Investigators
Jul 24, 2010·JACC. Cardiovascular Interventions·Hendrik-Jan DiekerFreek W A Verheugt
Dec 14, 2011·Stroke; a Journal of Cerebral Circulation·Young Seo KimByung-Woo Yoon
Jan 17, 2012·Stroke; a Journal of Cerebral Circulation·Haiqiang JinUNKNOWN ChinaQUEST (Quality Evaluation of Stroke Care and Treatment) Investigators
Jun 7, 2012·Stroke; a Journal of Cerebral Circulation·Sarah Song, Jeffrey Saver
May 21, 2013·Lancet Neurology·Klaus FassbenderJames Grotta
Jun 20, 2013·JAMA : the Journal of the American Medical Association·Jeffrey L SaverLee H Schwamm
Jul 3, 2013·JAMA Neurology·Shyam PrabhakaranMark J Alberts
Oct 10, 2013·Stroke; a Journal of Cerebral Circulation·Sam SchubergNerses Sanossian
Nov 22, 2013·International Journal of Stroke : Official Journal of the International Stroke Society·Beom Joon KimUNKNOWN CRCS-5 investigators
Jul 2, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Dae-Hyun KimJae-Taeck Huh

❮ Previous
Next ❯

Citations

Jul 24, 2018·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·J FladtG M De Marchis
Mar 3, 2020·Frontiers in Neurology·Andrew P ReimerBelinda L Udeh
Apr 21, 2021·International Journal of Stroke : Official Journal of the International Stroke Society·Ahmed MohamedMaher Saqqur

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.