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“卒中代码”快速反应团队的影响:提高急性缺血性卒中静脉溶栓率及缩短门针时间的尝试

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.

作者信息

Gurav Sushma K, Zirpe Kapil G, Wadia R S, Naniwadekar Avinash, Pote Prajakta U, Tungenwar Amit, Deshmukh Abhijeet M, Mohopatra Srikanta, Nimavat Balakrishna, Surywanshi Prasad

机构信息

Neuro Trauma Unit, Ruby Hall Clinic, Pune, Maharashtra, India.

Department of Neurology, Ruby Hall Clinic, Pune, Maharashtra, India.

出版信息

Indian J Crit Care Med. 2018 Apr;22(4):243-248. doi: 10.4103/ijccm.IJCCM_504_17.

Abstract

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 ( < 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.

摘要

目的

医院实施“卒中代码”(SC)可提高溶栓率并缩短卒中患者的治疗时间线。

材料与方法

分析了实施“SC”后(SC时代后)治疗急性缺血性卒中(AIS)患者的前瞻性数据(2015 - 2016年),并与“SC时代前”治疗患者的回顾性数据进行比较。计算了症状到入院、入院到医生、入院到影像检查、入院到穿刺(DTN)以及症状到穿刺时间等参数。使用美国国立卫生研究院卒中量表(NIHSS)计算治疗前后的卒中严重程度。

结果

SC时代前和时代后出现卒中症状的患者分别为695例和610例,其中处于窗口期前来就诊的患者分别为148例(21%)和210例(34%)。SC时代前和时代后接受溶栓治疗的患者分别为44例(29.7%)和65例(44.52%)。SC时代前平均DTN时间为104.95分钟,SC实施后降至67.28分钟(<0.001)。SC时代前和时代后在DTN时间≤60分钟内接受溶栓治疗的患者百分比分别为15.90%和55.38%。

结论

实施SC有助于提高AIS的溶栓率并缩短DTN时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df10/5930528/7e5f877d1699/IJCCM-22-243-g001.jpg

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