Shenzhen stroke emergency map improves access to rt-PA for patients with acute ischaemic stroke

Prehospital delay is one of the major causes of low rate of intravenous recombinant tissue plasminogen activator (rt-PA) thrombolysis for acute ischaemic stroke in China. Regional emergency systems have been proven a successful approach to improve access to thrombolysis. Shenzhen is a high populatio...

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Bibliographic Details
Published in:Stroke and vascular neurology 2019-09, Vol.4 (3), p.115-122
Main Authors: Ye, Shisheng, Hu, Shiyu, Lei, Zhihao, Li, Zhichao, Li, Weiping, Sui, Yi, Ren, Lijie
Format: Article
Language:English
Subjects:
acute ischemic stroke
Certification
China
Delivery of Health Care - organization & administration
Emergency Medical Services - organization & administration
Fibrinolytic Agents - administration & dosage
First aid
Hospitals
Humans
Ischemic Stroke - diagnosis
Ischemic Stroke - drug therapy
Maps as Topic
Original
Original article
Patients
Performance evaluation
qualified local hospitals
Quality management
Regional Health Planning - organization & administration
Retrospective Studies
Stroke
stroke emergency map
thrombectomy
thrombolysis
Thrombolytic Therapy
Time Factors
Time-to-Treatment - organization & administration
Transportation of Patients - organization & administration
Treatment Outcome
triage protocol
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Summary:Prehospital delay is one of the major causes of low rate of intravenous recombinant tissue plasminogen activator (rt-PA) thrombolysis for acute ischaemic stroke in China. Regional emergency systems have been proven a successful approach to improve access to thrombolysis. Shenzhen is a high population density city with great geographical disparity of healthcare resources, leading to limited access to rt-PA thrombolysis for most patients with acute ischaemic stroke. To improve rapid access to rt-PA thrombolysis in Shenzhen, a Shenzhen stroke emergency map was implemented by Shenzhen healthcare administrations. This map comprised certification of qualified local hospitals, identification of patients with stroke, acute stroke transport protocol and maintenance of the map. We conducted a retrospective observational study to compare consecutive patients with acute stroke arriving at qualified local hospitals before and after implementation of the Shenzhen stroke emergency map. After implementation of the map, the rate of patients receiving rt-PA thrombolysis increased from 8.3% to 9.7% (p=0.003), and the rate of patients treated with endovascular thrombectomy increased from 0.9% to 1.6% (p
ISSN:2059-8688
2059-8696
DOI:10.1136/svn-2018-000212