Improving Door-to-Needle Times A Single Center Validation of the Target Stroke Hypothesis
Improving Door-to-Needle Times A Single Center Validation of the Target Stroke Hypothesis
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DOI：
10.1161/strokeaha.113.004073
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发表时间：
2014-02-01
期刊：
影响因子：
8.3
通讯作者：
Schwamm, Lee H.
中科院分区：
文献类型：
--
作者：
Ruff, Ilana M.;Ali, Syed F.;Schwamm, Lee H.
背景和目的国家指南建议急性卒中患者在到达急诊室后25分钟内进行影像学检查，在到达急诊室后60分钟内静脉注射组织型纤溶酶原激活剂。二零零七年，我们实施了一个新的机构急性卒中护理模式，其中包括10个最佳实践，并评估了这种干预对改善我院门到计算机断层扫描（CT）和门到针（DTN）时间的影响。（2003-2006年）和干预后（2008-2011年）时期。我们没有包括2007年，即新协议制定的那一年。预测DTN的60分钟之前和之后的干预进行了评估，使用（2）的分类变量，t检验和Wilcoxon符号秩检验的连续variable.Results在2595例急性卒中患者中，284（11%）接受静脉注射组织型纤溶酶原激活剂。对于在静脉注射组织型纤溶酶原激活剂窗口期内到达的患者，
Background and Purpose National guidelines recommend imaging within 25 minutes of emergency department arrival and intravenous tissue-type plasminogen activator within 60 minutes of emergency department arrival for patients with acute stroke. In 2007, we implemented a new institutional acute stroke care model to include 10 best practices and evaluated the effect of this intervention on improving door-to-computed tomography (CT) and door-to-needle (DTN) times at our hospital.Methods We compared patients who presented directly to our hospital with acute ischemic stroke in the preintervention (2003-2006) and postintervention (2008-2011) periods. We did not include 2007, the year that the new protocol was established. Predictors of DTN 60 minutes before and after the intervention were assessed using (2) for categorical variables, and t test and Wilcoxon signed-rank test for continuous variables.Results Among 2595 patients with acute stroke, 284 (11%) received intravenous tissue-type plasminogen activator. For patients arriving within an intravenous tissue-type plasminogen activator window, door-to-CT