Door To Needle Time In Acute Stroke

Man s et al association between thrombolytic door to needle time and 1 year mortality and readmission in patients with acute ischemic stroke jama 2020.

Door to needle time in acute stroke.

However fewer than one third of acute ischemic stroke patients who receive tpa are treated within guideline recommended door to needle times. Findings in this us retrospective cohort study that included 61 426 patients with acute ischemic stroke treated with intravenous tissue plasminogen activator longer door to needle times within 90. The benefits of tpa in patients with acute ischemic stroke are time dependent and guidelines recommend a door to needle time. Stroke launched by the american heart association american stroke association in 2010 is a national quality improvement initiative focused on improving acute ischemic stroke care by reducing door to needle times for eligible patients being treated with tpa.

Lowering the median dnt is an essential goal for quality improvement and is therefore used worldwide in audits for this. However these associations. Every 15 minute increase in door to needle times after 60 minutes of hospital arrival was significantly associated with higher cardiovascular readmission secondary outcome adjusted hr 1 02 95 ci 1 01 1 04 and higher stroke readmission a post hoc secondary out come adjusted hr 1 02 95 ci 1 00 1 04. A national institute of neurological disorders and stroke national symposium on the rapid identification and treatment of acute stroke recommended a door to needle target time of 60 minutes.

The door to needle time dnt the time from presentation of patient with symptoms at the hospital to the start of ivt can therefore be used to evaluate the quality of the acute stroke care provided by each hospital.