Direct admission to stroke centers reduces treatment delay and improves clinical outcome after intravenous thrombolysis
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
Intravenous tissue plasminogen activator for acute ischemic stroke: A Canadian hospital's experience
Geographic differences in acute stroke care in Catalunya: impact of a regional interhospital network
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