Stroke admission outside daytime working hours delays mechanical thrombectomy and worsens short-term outcome

International Journal of Stroke : Official Journal of the International Stroke Society
Robert HoepnerC Krogias

Abstract

Rapid therapeutic decisions in acute stroke patients leading to earlier initiation of revascularization therapies are associated with better outcome. An association between regular working hours and reduced time to initiation of intravenous thrombolysis has been reported. However, its influence on mechanical thrombectomy (MT) remains uncertain. We aimed to analyze the effects of admission time on door-to-groin time and stroke outcome in a large prospective stroke registry of the Neurovascular Net Ruhr in Germany. Procedural times of a total of 512 patients treated with MT were analyzed. Admission to hospital during regular working days and hours (Monday to Friday, 8 am to 4 pm) was compared with admission outside these times. Door-to-groin time and the difference in NIH Stroke Scale between admission and discharge served as primary outcome parameters. Long-term functional outcome was centrally assessed with modified Rankin scale. MT outside regular working hours was associated with a significant mean initiation delay of 20 min. By multivariate regression analysis, every 20 min delay of MT reduced the difference in NIHSS score between admission and discharge by 0.76 points (95% CI -1.24 to -0.28, p = 0.002). Favorable long-term ...Continue Reading

References

Mar 10, 2007·Stroke; a Journal of Cerebral Circulation·Gustavo SaposnikVladimir Hachinski
May 25, 2012·Neurology·Atte MeretojaMarkku Kaste
May 21, 2013·Lancet Neurology·Klaus FassbenderJames Grotta
Dec 10, 2014·Research in Gerontological Nursing·Allison Lindauer, Theresa A Harvath
Mar 19, 2016·Expert Review of Neurotherapeutics·Georgios TsivgoulisAndrei V Alexandrov
Mar 24, 2016·Therapeutic Advances in Neurological Disorders·Ralph WeberUNKNOWN Neurovascular Net Ruhr
Nov 10, 2017·Nature Biotechnology·J Benjamin HurlbutLaurie Zoloth

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Citations

Sep 3, 2020·BMC Neurology·Jake WeddellChristine Roffe
Jan 22, 2021·International Journal of Stroke : Official Journal of the International Stroke Society·Juliane HermChristian H Nolte
Apr 21, 2021·International Journal of Stroke : Official Journal of the International Stroke Society·Mingming ZhaXinfeng Liu

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