Door to needle time and functional outcome for mild ischemic stroke over telestroke

Journal of Telemedicine and Telecare
Jillian B HarveyChristine A Holmstedt

Abstract

Faster intravenous alteplase (tPA) administration from time of symptom onset is associated with better functional outcome. Lack of recognition of mild ischemic stroke (MIS) might result in delay in treatment with tPA. We hypothesise that patients with MIS have a longer door to needle (DTN) time when compared to patients with severe stroke symptoms. Data on all patients who received tPA at spoke hospitals through the Medical University of South Carolina (MUSC) telestroke network were analysed. Collected data included baseline characteristics, stroke severity on presentation measured by the National Institute of Health Stroke Scale (NIHSS), the rate of symptomatic intracerebral haemorrhage, discharge location, and discharge functional outcome measured by the modified Rankin scale. Of the 454 patients treated with tPA through the MUSC telestroke network in the period from January 2013 to April 2017, 98 (22%) had MIS defined as NIHSS ≤ 5 on presentation; the remaining 356 (78%) patients were found to have severe stroke defined as NIHSS > 5 on presentation. Patients presenting with MIS were found to have a delay in receiving intravenous tPA by ∼10 min (p = 0.007) and approximately 15% of them had poor functional outcome at discharge...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
Jun 17, 1998·Stroke; a Journal of Cerebral Circulation·J M FerroA V Salgado
Nov 25, 2003·European Neurology·Thierry MoulinLucien Rumbach
Jan 24, 2004·Stroke; a Journal of Cerebral Circulation·Dawn KleindorferUNKNOWN Neuroscience Institute
Mar 16, 2004·Lancet·Werner HackeUNKNOWN NINDS rt-PA Study Group Investigators
May 18, 2005·Journal of Neurology, Neurosurgery, and Psychiatry·N U Weir, A M Buchan
Dec 13, 2005·Stroke; a Journal of Cerebral Circulation·Jeffrey L Saver
May 10, 2006·Archives of Neurology·Kara Z BambauerJustin A Zivin
May 30, 2009·Stroke; a Journal of Cerebral Circulation·Debbie SummersUNKNOWN American Heart Association Council on Cardiovascular Nursing and the Stroke Council
Nov 10, 2010·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Khurshid KhanPatrick Crumley
Nov 23, 2011·International Journal of Stroke : Official Journal of the International Stroke Society·Joshua Z WilleyRandolph S Marshall
Dec 27, 2011·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Christos LazaridisRobert J Adams
Mar 26, 2013·International Journal of Stroke : Official Journal of the International Stroke Society·Amrou SarrajSean I Savitz
Jun 20, 2013·JAMA : the Journal of the American Medical Association·Jeffrey L SaverLee H Schwamm
Nov 12, 2016·Stroke; a Journal of Cerebral Circulation·Syed F AliLee H Schwamm
Feb 9, 2017·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Sami Al KasabChristine Ann Holmstedt
Jul 29, 2017·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Sami Al KasabChristine A Holmstedt

❮ Previous
Next ❯

Citations

Mar 5, 2020·Circulation. Cardiovascular Quality and Outcomes·Richa SharmaLee H Schwamm
May 14, 2020·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Eyad AlmallouhiSami Al Kasab
Dec 11, 2019·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Philip W TiptonWilliam D Freeman
Sep 27, 2018·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Eyad AlmallouhiSami Al Kasab

❮ Previous
Next ❯

Software Mentioned

MUSC

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.