Stroke Literature Synopses: Clinical Science
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Prabhakaran S, O’Neill K, Stein-Spencer L, Walter J, Alberts MJ. Prehospital triage to primary stroke centers and rate of stroke thrombolysis. JAMA Neurol. 2013;70:1126–1132.
Using the Get With The Guidelines database, Prabhakaran et al retrospectively assessed rates of intravenous thrombolysis at 10 Chicago primary stroke centers (PSCs) in the 6 months before and 6 months after the institution of a citywide policy recommending prehospital triage of patients with suspected stroke to the nearest PSC. Before prehospital triage, 1075 patients with stroke and transient ischemic attack were admitted to the 10 PSCs; post-triage, 1172 were admitted. The proportion of stroke/transient ischemic attack admissions presenting by ambulance increased from 30.2% pretriage to 38.1% post-triage, hospital prenotification increased from 65.5% to 76.5%, rates of intravenous tissue plasminogen activator (tPA) delivery increased from 3.8% to 10.1%, and onset-to-treatment times decreased from 171.7 to 145.7 minutes (all P<0.05). Stroke unit admission, symptomatic intracranial hemorrhage rates, and in-hospital mortality were not significantly different between periods. Adjusting for mode of arrival, prehospital notification, and onset-to-arrival time, …