Stroke Literature Synopses: Clinical Science

Introduction

Fonarow GC, Zhao X, Smith EE, Saver JL, Reeves MJ, Bhatt DL, et al. Door-to-needle times for tissue plasminogen activator administration and clinical outcomes in acute ischemic stroke before and after a quality improvement initiative. JAMA. 2014;311:1632–1640.

Studies have shown that the time from symptom onset to thrombolytic initiation is a critical factor affecting stroke outcomes. Nevertheless, <30% of stroke patients who receive thrombolytic therapy have a door-to-needle (DTN) time within the recommended 60 minutes. Target: Stroke was a national quality improvement initiative designed to increase the proportion of stroke survivors receiving tissue plasminogen activator <60 minutes of hospital arrival to >50%.¹ All Get-With-The-Guidelines (GWTG) participating hospitals were encouraged to participate.

To evaluate the impact of Target: Stroke on acute stroke care and outcomes, Fonarow et al compared DTN times of tissue plasminogen activator administration in patients with acute ischemic stroke before (2003–2009; n=27 319) and after (2010–2013; n=43 850) the implementation of …