Target Door-to-Needle Time for Tissue Plasminogen Activator Treatment with Magnetic Resonance Imaging Screening Can Be Reduced to 45 min
Target Door-to-Needle Time for Tissue Plasminogen Activator Treatment with Magnetic Resonance Imaging Screening Can Be Reduced to 45 min
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DOI：
10.1159/000489568
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发表时间：
2018-01-01
影响因子：
2.9
通讯作者：
Bonafe, Alain
中科院分区：
文献类型：
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作者：
Sablot, Denis;Ion, Ioana;Bonafe, Alain
目的：本研究的目的是证明，在初级卒中中心，通过基于 MRI 的急性缺血性卒中 (AIS) 筛查，静脉组织纤溶酶原激活剂 (tPA) 治疗的中位到针 (DTN) 时间可以缩短至 45 分钟。方法：2015年2月至2017年2月，法国佩皮尼昂综合医院卒中科室实施了质量改进（QI）流程。在此期间，AIS 发病后 4.5 小时内接受 tPA 的患者被纳入 QI 队列。每个学期都会对他们的临床特征和时间指标进行比较，并与 QI 前 1 年期间接受 tPA 治疗的连续 135 名 AIS 患者（QI 前队列）进行比较。结果：在 QI 队列中，274 名患者 (92.5%) 接受了 MRI 筛查。虽然队列之间的人口统计和基线特征没有显着差异，但 QI 中的中位 DTN 时间显着低于 QI 前队列（52 分钟与 84 分钟；p < 0.00001）。在 QI 队列中，每学期的中位 DTN 时间从 65 分钟减少到 44 分钟 (p < 0.00001)，并且接受 DTN 时间治疗的患者比例
Objective: 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). Methods: 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). Results: 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