Abstract WP355: Impact of Target Stroke on Reducing Door-to-Needle Times
Background: Intravenous tissue plasminogen activator (IV-tPA) is the only FDA approved drug treatment for Acute Ischemic Stroke (AIS) within 3 hours or less from onset of stroke symptoms. The guidelines also recommend that stroke centers be able to administer IV-tPA in less than 60 minutes from the time the patients arrive, door-to-needle (DTN) time. Since less than one third of hospitals achieve this DTN goal, the American Stroke Association developed a national initiative to reduce the door to needle time called “Target Stroke” (TS).
Methods: A retrospective analysis was conducted of DTN times on 59 consecutive patients receiving IV-tPA at the University of Louisville Hospital from January 2009 to July, 2012. TS was instituted the fourth quarter of 2011. The percentage of patients meeting the target DTN time of less than 60 minutes was compared before and after TS was instituted (Quarter 1 and 2, 2011 vs Q1-2, 2012). Q1-2, 2010 and Q1-2, 2009 were also compared to Q1-2, 2012. Data were analyzed using 2X2 Fisher’s exact test. A two-tailed probability value of p<0.05 was considered significant.
Results: The data show a statistically significant association between DTN time in less than 60 minutes and target stroke implementation (p<0.001, Q1-2, 2011 vs Q1-2, 2012; p<0.001, Q1-2, 2010 vs Q1-2, 2012 and p<0.020 Q1-2, 2009 vs Q1-2, 2012).
Conclusions/Discussion: More patients received IV-tPA in less than 60 minutes after implementation of TS than before. Utilization of TS significantly improved DTN times at University of Louisville Hospital. Our next step will be to compare outcomes for the same data set using discharge modified Rankin Scale and discharge disposition.
- © 2012 by American Heart Association, Inc.