Pre-hospital notification reduced the door-to-needle time for iv t-PA in acute ischaemic stroke
Pre-hospital notification reduced the door-to-needle time for iv t-PA in acute ischaemic stroke
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DOI：
10.1111/j.1468-1331.2009.02762.x
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发表时间：
2009-12-01
影响因子：
5.1
通讯作者：
Cha, J. K.
中科院分区：
文献类型：
--
作者：
Kim, S. K.;Lee, S. Y.;Cha, J. K.
背景与目的：院内延迟是急性缺血性脑卒中（AIS）溶栓治疗的最大障碍。我们实施了院前通知系统从紧急医疗信息系统在我们的大都市地区，以减少院内delay.Methods：从2007年10月，我们实施了24小时热线系统之间的中风中心和韩国紧急医疗信息系统在釜山。我们比较了处理时间和临床结果之间的患者使用静脉注射组织型纤溶酶原激活剂（iv t-PA）后，没有热线system.Results：院前通知系统实施后，静脉注射t-PA的使用率从6.5%上升到14.3%。有院前通知的患者的发病时间远长于无院前通知的患者（121.5 +/- 34.8 min vs. 74.7 +/- 38.5 min，P < 0.01），但门到针的时间显著缩短（28.9 +/- 11.4 min vs. 47.7 +/- 22.8 min，P < 0.01）。然而，有90天的临床outcomes between the two groups.Conclusions：院前通知系统减少院内处理时间，导致AIS后增加iv t-PA的使用没有显着差异。然而，改善溶栓治疗的临床结局可能不仅需要组织院内流程，还需要组织外部流程，例如早期识别和快速派遣疑似AIS患者。
Background and purpose:Intrahospital delay is the most serious obstacle in thrombolysis in acute ischaemic stroke (AIS). We implemented the pre-hospital notification system from the emergency medical information system in our metropolitan area to reduce intrahospital delay.Methods:From October 2007, we implemented a 24-h hotline system between our stroke center and the Korean Emergency Medical Information System in Busan. We compared processing times and clinical outcomes amongst patients after using intravenous tissue type plasminogen activator (iv t-PA) with and without the hotline system.Results:After the pre-hospital notification system was implemented, the rate of iv t-PA use increased from 6.5% to 14.3%. Time of onset in patients with pre-hospital notification was much longer than in patients without (121.5 +/- 34.8 min vs. 74.7 +/- 38.5 min, P < 0.01) notification but door-to-needle time was significantly reduced (28.9 +/- 11.4 min vs. 47.7 +/- 22.8 min, P < 0.01). However, there were no significant differences in 90-day clinical outcomes between the two groups.Conclusions:The pre-hospital notification system reduced intrahospital processing times which led to increased iv t-PA use after AIS. However, the improvement of clinical outcomes in thrombolysis might require organization of not only intrahospital processes but of outside processes such as the early recognition and rapid dispatch of patients with suspected AIS.