Bu Julia Ting, Meyer Dawn M, Shifflett Benjamin, Meyer Brett C
Comprehensive Stroke Center, University of California San Diego, 9444 Medical Center Drive, La Jolla, CA, 92037-0979, USA.
Neurol Res Pract. 2024 Jun 13;6(1):31. doi: 10.1186/s42466-024-00319-2.
To examine the influence of interpreter service needs (IS) on rt-PA administration time metrics.
Retrospectively reviewed prospectively collected data from Comprehensive Stroke Center database (January 2011- April 1, 2021) and EMR.
Subjects for whom a "stroke code" was activated. Excluded in-house strokes. Baseline characteristics, frequency of rt-PA, rt-PA exclusions and time metrics, NIHSS were compared between patients who did or did not require IS. Analyses utilized ANOVA, t-Test, Brown-Mood Median Test, or Pearson's Chi-squared test as appropriate.
Of 2,191 patients with stroke code activations, 81 had a documented need for IS. Rt-PA was administered in 9 IS and 358 non-IS patients. Median baseline NIHSS was higher in rt-PA group (9±8 vs 3±9, p<0.005). In IS patients, there were no differences in baseline characteristics between those who received rt-PA and those who did not, including median score for NIHSS aphasia (0±1 vs 0±1, p = 0.46). There were no rt-PA rate differences between those that did not and did require IS (17% vs 11%, p = 0.22). In patients with final diagnosis acute ischemic stroke, patients excluded from rt-PA solely due to being out of the window were more likely to have required IS (59% vs 35%, p = 0.003). Time metrics of rt-PA administration were not different in IS patients.
There was no significant difference in frequency or time metrics of rt-PA administration in patients requiring interpreter services during an acute stroke code. AIS patients requiring an interpreter were more likely to be excluded from rt-PA on the basis of time.
探讨口译服务需求(IS)对重组组织型纤溶酶原激活剂(rt-PA)给药时间指标的影响。
回顾性分析前瞻性收集的综合卒中中心数据库(2011年1月至2021年4月1日)和电子病历(EMR)中的数据。
激活“卒中代码”的患者。排除院内卒中患者。比较需要或不需要口译服务的患者的基线特征、rt-PA使用频率、rt-PA排除情况和时间指标、美国国立卫生研究院卒中量表(NIHSS)评分。分析根据情况采用方差分析、t检验、布朗-穆德中位数检验或Pearson卡方检验。
在2191例激活卒中代码的患者中,有81例记录有口译服务需求。9例有口译服务需求的患者和358例无口译服务需求的患者接受了rt-PA治疗。rt-PA治疗组的基线NIHSS中位数更高(9±8 vs 3±9,p<0.005)。在有口译服务需求的患者中,接受rt-PA治疗和未接受rt-PA治疗的患者在基线特征上没有差异,包括NIHSS失语中位数评分(0±1 vs 0±1,p = 0.46)。需要和不需要口译服务的患者之间rt-PA使用率没有差异(17% vs 11%,p = 0.22)。在最终诊断为急性缺血性卒中的患者中,仅因超出时间窗而被排除在rt-PA治疗之外的患者更有可能需要口译服务(59% vs 35%,p = 0.003)。有口译服务需求的患者rt-PA给药的时间指标没有差异。
在急性卒中代码期间,需要口译服务的患者在rt-PA给药频率或时间指标上没有显著差异。需要口译服务的急性缺血性卒中(AIS)患者更有可能因时间原因被排除在rt-PA治疗之外。