The golden hour of acute ischemic stroke

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Rajiv AdvaniMartin W Kurz

Abstract

Acute Ischemic Stroke (AIS) treatment has been revolutionised in the last two decades with the increasing use of Intravenous Thrombolysis (IVT) and with the advent of Endovascular therapy (EVT). AIS treatment and outcome are time dependant and time saving measures are being implemented at every step of the treatment chain. These changes have resulted in lower treatment times in-hospital, but it is unclear if this translates into more patients being treated within 60 min of symptom onset - the Golden Hour. The clinical outcome of IVT therapy in this patient group was our secondary outcome. From 2009 onwards, systematic changes were made to the AIS treatment chain leading to a dramatic decrease in Door-to-Needle (DTN) time. Analyses were performed on the number of these treatments year on year and their clinical outcomes within the Golden Hour at Stavanger University Hospital (SUS). Six-hundred and thirteen patients were included; seventy-three were treated within the Golden Hour. The percentage of total IVT treatments occurring in the Golden Hour rose from 2.2% in 2009 to 14.5% in 2015 (p = 0.006) with a high of 18.3% in 2012 (p < 0.001). All of these patients had a Median NIHSS of 0 at discharge, irrespective of age and pre-exi...Continue Reading

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Citations

Nov 15, 2018·Acta Anaesthesiologica Scandinavica·Karianne LarsenHans Morten Lossius
Jun 23, 2020·Stroke; a Journal of Cerebral Circulation·Martin W KurzMayank Goyal
Sep 15, 2020·Therapeutic Advances in Neurological Disorders·Vida AbediRamin Zand
Dec 15, 2019·Brain and Behavior·Rajiv AdvaniMartin W Kurz
May 11, 2021·Current Cardiology Reports·Jithendhar KandimallaRakesh Khatri
Jul 30, 2021·PloS One·Luz M MoyanoUNKNOWN Cysticercosis Working Group for Peru

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