Thrombolytic Administration for Acute Ischemic Stroke

Abstract

Background: The therapeutic benefit of tissue plasminogen activator (tPA) for acute ischemic stroke is provenbut extremely time-dependent. Current guidelines recommend a 4.5 hours. We used a linear regression model to quantify factor influence and compared tPA administration benchmark times to target benchmark times (median + quartiles). Results: Among the 71 ischemic stroke patients included, 38 (54%) received tPA within ≤ 60 minutes. Female sex was associated with a door-to-needle time delay of 13.97 minutes (95% CI 3.412 to 27.111). Median benchmark times did not show evidence of delay in any benchmark in comparison with target benchmark times. Conclusion: Female sex was associated with increased door-to-needle time. Further investigation of these areas may enable optimized workflow, decreased door-to-needle times, and improved patient outcomes.

Keywords

• Stroke
• Thrombolysis
• Emergency Department
• Workflow