Target Door-to-Needle Time for Tissue Plasminogen Activator Treatment with Magnetic Resonance Imaging Screening Can Be Reduced to 45 min

Cerebrovascular Diseases
D SablotAlain Bonafe

Abstract

The purpose of this study was to demonstrate that the median door-to-needle (DTN) time for intravenous tissue plasminogen activator (tPA) treatment can be reduced to 45 min in a primary stroke centre with MRI-based screening for acute ischaemic stroke (AIS). From February 2015 to February 2017, the stroke unit of Perpignan general hospital, France, implemented a quality-improvement (QI) process. During this period, patients who received tPA within 4.5 h after AIS onset were included in the QI cohort. Their clinical characteristics and timing metrics were compared each semester and also with those of 135 consecutive patients with AIS treated by tPA during the 1-year pre-QI period (pre-QI cohort). In the QI cohort, 274 patients (92.5%) underwent MRI screening. While the demographic and baseline characteristics were not significantly different between cohorts, the median DTN time was significantly lower in the QI than in the pre-QI cohort (52 vs. 84 min; p < 0.00001). Within the QI cohort, the median DTN time for each semester decreased from 65 to 44 min (p < 0.00001) and the proportion of treated patients with a DTN time ≤45 min increased from 25 to 58.9% (p < 0.0001). Overall, DTN time improvement was associated with a better ou...Continue Reading

References

Sep 19, 2009·Journal of Neurology, Neurosurgery, and Psychiatry·A KruetzelmannG Thomalla
Aug 9, 2011·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·James S McKinneyMark A Merlin
Nov 26, 2011·AJNR. American Journal of Neuroradiology·N GaillardC Arquizan
Mar 20, 2012·Stroke; a Journal of Cerebral Circulation·Robert MikulíkUNKNOWN Safe Implementation of Treatments in Stroke-East Registry (SITS-EAST) Investigators
May 25, 2012·Neurology·Atte MeretojaMarkku Kaste
Jul 13, 2012·Circulation. Cardiovascular Quality and Outcomes·Cheryl B LinGregg C Fonarow
Nov 10, 2012·Stroke; a Journal of Cerebral Circulation·Andria L FordJin-Moo Lee
Jun 20, 2013·JAMA : the Journal of the American Medical Association·Jeffrey L SaverLee H Schwamm
Mar 15, 2014·Stroke; a Journal of Cerebral Circulation·Atte MeretojaLeonid Churilov
Apr 10, 2014·Stroke; a Journal of Cerebral Circulation·Ying XianGregg C Fonarow
Jun 12, 2014·Stroke; a Journal of Cerebral Circulation·Kambiz NaelChelsea S Kidwell
Apr 15, 2015·JAMA : the Journal of the American Medical Association·Shyam PrabhakaranRichard A Bernstein
May 15, 2015·Neurology·Shreyansh ShahAmie W Hsia
Nov 4, 2015·JAMA : the Journal of the American Medical Association·Jetan H BadhiwalaSaleh A Almenawer
Jan 15, 2016·International Journal of Stroke : Official Journal of the International Stroke Society·Nils WahlgrenUNKNOWN ESO-KSU, ESO, ESMINT, ESNR and EAN
Feb 24, 2017·Stroke; a Journal of Cerebral Circulation·Noreen KamalEric E Smith

❮ Previous
Next ❯

Citations

Nov 22, 2019·Neurology. Clinical Practice·Denis SablotAlain Bonafe

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.