Pre-hospital notification is associated with improved stroke thrombolysis timing

Intravenous thrombolysis increases disability-free survival after acute ischaemic stroke in a time-dependent fashion. We aimed to determine whether pre-hospital notification, introduction of a CT scanner near to assessment site and introduction of out-of-hours thrombolysis services affect thrombolys...

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Bibliographic Details
Published in:The Journal of the Royal College of Physicians of Edinburgh 2015-01, Vol.45 (3), p.190-195
Main Authors: Khor, M X, Bown, A, Barrett, A, Counsell, C E, MacLeod, M J, Reid, J M
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Ambulances
Communication
Emergency Service, Hospital
Female
Hospitalization
Hospitals
Humans
Logistic Models
Male
Middle Aged
Odds Ratio
Physicians
Severity of Illness Index
Stroke - diagnostic imaging
Stroke - therapy
Thrombolytic Therapy
Time-to-Treatment
Tomography, X-Ray Computed
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Summary:Intravenous thrombolysis increases disability-free survival after acute ischaemic stroke in a time-dependent fashion. We aimed to determine whether pre-hospital notification, introduction of a CT scanner near to assessment site and introduction of out-of-hours thrombolysis services affect thrombolysis timing. Methods Timings related to thrombolysis were collected between May 2012 and June 2014 at a single hospital site; these included time to stroke physician assessment, time to cranial CT imaging and door to needle time. All thrombolysed ischaemic stroke patients admitted via the emergency department were included. Ambulance services were asked to pre-notify the emergency department of any suspected stroke patient during this period. Results We studied 182 patients (48% female; mean age 74 years; 59% pre-notified). Pre-hospital notification was associated with a significantly higher rate of CT scanning within 25 minutes (60% vs 24%, odds ratio [OR] 4.7, 95% confidence interval [CI] 2.4-9.0; p
ISSN:1478-2715
2042-8189
DOI:10.4997/JRCPE.2015.303