Stroke fast track reduces time delay to neuroimaging and increases use of thrombolysis in an academic medical center in Thailand.

Abstract

Delays between hospital arrival and neuroimaging prevented patients from receiving thrombolysis. We report impact of Stroke Fast Track (SFT) on time to imaging, and rates of recombinant tissue plasminogen activator (rt-PA) in eligible patients. Characteristics, time intervals, and rates of rt-PA were evaluated in 464 patients with suspected acute stroke within 7 days (2005-2006). Complete time intervals were available on 380. Median times between emergency room arrival, brain computerized tomography (CT), and CT results were 25 and 45 minutes, respectively, for patients arriving <3 hours from onset, 40, and 65 minutes for those arriving >3 hours, and 35 and 60 minutes for all patients, which is significantly shorter than 2.5 hours to CT in 2004, prior to SFT (P < .0001). Although not different in time to first physician, patients arriving >3 hours had longer times to CT and CT results (P < .001). Overall, 5.5% of ischemic stroke patients received intravenous rt-PA, including 27.1% of those arriving within 3 hours, which represented 100% of all eligible patients, compared with 0% in 2004. SFT reduced time delay in neuroimaging and increased use of rt-PA in Thailand. Continuous quality improvement is needed to achieve best results in each setting, and to insure optimal care for acute stroke patients.

• Authors: Disya Ratanakorn, Jesada Keandoungchun, Yuwares Sittichanbuncha, Jiraporn Laothamatas, Charles H Tegeler
• Journal: Journal of neuroimaging : official journal of the American Society of Neuroimaging (J Neuroimaging) Vol. 22 Issue 1 Pg. 53-7 (Jan 2012) ISSN: 1552-6569 [Electronic] United States
• PMID: 21122006 (Publication Type: Journal Article)
• Copyright: Copyright © 2010 by the American Society of Neuroimaging.

Chemical References

• Tissue Plasminogen Activator

Topics

• Academic Medical Centers (statistics & numerical data)
• Adult
• Aged
• Aged, 80 and over
• Female
• Hospitalization (statistics & numerical data)
• Humans
• Male
• Mechanical Thrombolysis (statistics & numerical data)
• Middle Aged
• Neuroimaging (statistics & numerical data)
• Stroke (diagnosis, epidemiology, therapy)
• Thailand (epidemiology)
• Time Management (methods)
• Tissue Plasminogen Activator (therapeutic use)
• Treatment Outcome
• Waiting Lists
• Young Adult