Clinical significance of stroke nurse in patients with acute ischemic stroke receiving intravenous thrombolysis

Background Reports have proven that shorter door-to-needle time (DTN time) indicates better outcomes in AIS patients received intravenous thrombolysis. Efforts have been made by hospitals and centers to minimize DTN time in many ways including introducing a stroke nurse. However, there are few studi...

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Published in:BMC neurology 2021-09, Vol.21 (1), p.1-359, Article 359
Main Authors: Xu, Zhao-Han, Deng, Qi-Wen, Zhai, Qian, Zhang, Qing, Wang, Zhen-Jie, Chen, Wen-Xia, Gu, Meng-Meng, Jiang, Teng, Zhou, Jun-Shan, Zhang, Ying-Dong
Format: Article
Language:English
Subjects:
Acute ischemic stroke
Care and treatment
Clinical significance
Comparative analysis
Contraindications
Door-to-needle time
Hospitals
Hypertension
Informed consent
Intravenous administration
Intravenous thrombolysis
Ischemia
Mediation
Nurses
Patients
Regression analysis
Services
Stroke
Stroke nurse
Stroke patients
Thrombolysis
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Summary:Background Reports have proven that shorter door-to-needle time (DTN time) indicates better outcomes in AIS patients received intravenous thrombolysis. Efforts have been made by hospitals and centers to minimize DTN time in many ways including introducing a stroke nurse. However, there are few studies to discuss the specific effect of stroke nurse on patients' prognosis. This study aimed to compare consecutive AIS patients before and after the intervention to analyze the effect of stroke nurse on clinical outcome of AIS patients. Methods In this retrospective study, we observed 1003 patients from November 2016 to December 2020 dividing in two groups, collected and analyzed AIS patients' medical history, clinical assessment information, important timelines, 90 mRS score, etc. Comparative analysis and mediation analysis were also used in this study. Results A total of 418 patients was included in this study, and 199 patients were enrolled in the stroke nurse group and 219 was in the preintervention group. Baseline characteristics of patients showed no significant difference except there seems more patients with previous ischemic stroke history in the group of stroke nurse. (p = 0.008). The median DTN time significantly decreased in the stroke nurse group (25 min versus 36 min, p < 0.001) and multivariate logistic regression analysis showed the 90-day mRS clinical outcome significantly improved in the stroke nurse group (p = 0.001). Mediation analysis indicated the reduction of DTN time plays a partial role on the 90 days mRS score and the stroke nurse has some direct effect on the improvement of clinical outcome (p = 0.006). Conclusions The introduction of stroke nurse is beneficial to clinical outcome of AIS patients and can be use of reference in other hospitals or centers. Keywords: Stroke nurse, Door-to-needle time, Acute ischemic stroke, Intravenous thrombolysis
ISSN:1471-2377
1471-2377
DOI:10.1186/s12883-021-02375-6