Background
Outcomes of acute stroke management are time dependent. Intravenous tissue plasminogen
activator (t-PA) is indicated within 3-4.5 hours of symptom onset and endovascular
intervention within 6 hours. Time to treatment may depend on the patient's location.
This study seeks to determine whether there is a difference in the timing of key aspects
of stroke codes between the emergency room and the inpatient setting.
Methods
Stroke codes ending in t-PA administration or endovascular intervention between 2010
and 2013 were included. Emergency room stroke codes were compared with those in the
inpatient setting. Data were obtained from the Yarmon Stroke Center log. The variables
were time to neurological evaluation, time to computed tomography (CT) scan, time
to t-PA administration, time from CT scan to t-PA, and time to endovascular intervention.
The variables were compared using the t test.
Results
One hundred twenty-two stroke codes were included (106 from emergency room and 16
from inpatient setting). There was no difference in the time to neurological evaluation
(P = .19). The time to CT scan and to t-PA administration was significantly increased
in the inpatient group (P ≤ .001 and P = .01, respectively). There was no difference in the time from CT scan to t-PA (P = .09) and in the time to endovascular intervention (P = .21).
Conclusions
Our results show that in the inpatient setting, there was a significant delay in the
time to CT scan and to t-PA administration and that the source of the delay is the
time to CT scan.
Key Words
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Article info
Publication history
Published online: June 04, 2015
Accepted:
May 7,
2015
Received in revised form:
May 1,
2015
Received:
April 2,
2015
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.05.010
Copyright
© 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.
