door to needle time, stroke code,Acute ischemic stroke
Citation Information :
Gurav S, Zirpe K, Wadia R, Naniwadekar A, Mohopatra S, Nimavat B, Surywanshi P. Impact of “Stroke Code”-Rapid response team: An attempt to improve intravenous thrombolysis rate and to shorten Door-to-Needle time in acute ischemic stroke. Indian J Crit Care Med 2018; 22 (4):243-248.
Objective: “Stroke code” (SC) implementation in hospitals can improve the rate of thrombolysis and the timeline in care of stroke patient.
Materials and Methods: A prospective data of patients treated for acute ischemic stroke (AIS) after implementation of “SC” (post-SC era) were analyzed (2015–2016) and compared with the retrospective data of patients treated in the “pre-SC era.” Parameters such as symptom-to-door, door-to-physician, door-to-imaging, door-to-needle (DTN), and symptom-to-needle time were calculated. The severity of stroke was calculated using the National Institutes of Health Stroke Score (NIHSS) before and after treatment.
Results: Patients presented with stroke symptoms in pre- and post-SC era (695 vs. 610) and, out of these, patients who came in window period constituted 148 (21%) and 210 (34%), respectively. Patients thrombolyzed in pre- and post-SC era were 44 (29.7%) and 65 (44.52%), respectively. Average DTN time was 104.95 min in pre-SC era and reduced to 67.28 min (P < 0.001) post-SC implementation. Percentage of patients thrombolyzed within DTN time ≤60 min in pre-SC era and SC era was 15.90% and 55.38%, respectively.
Conclusion: Implementation of SC helped us to increase thrombolysis rate in AIS and decrease DTN time.
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