Door To Needle Time In Acute Stroke

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.

Door to needle time in acute stroke.

The benefits of intravenous tissue type plasminogen activator tpa in acute ischemic stroke are time dependent and guidelines recommend a door to needle time of 60 minutes. Question is there an association between shorter door to needle time with thrombolytic therapy and long term mortality and hospital readmission in patients with acute ischemic stroke. 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. 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.

However these associations. 8 aha asa guidelines recommend the target for completion of initial evaluation and start of tpa treatment should be within 1 hour of the patient s arrival. 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. 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.

However fewer than one third of acute ischemic stroke patients who receive tpa are treated within guideline recommended door to needle times.