Abstract T P215: A Systemized Stroke Code Significantly Reduced Time Intervals For Using Iv t-pa Under MRI Screening
Background: A stroke code can shorten time intervals until intravenous tissue plasminogen activator (IV t-PA) treatment in acute ischemic stroke (AIS). Recently, several reports demonstrated that MRI based thrombolysis had reduced complications and improved outcomes in AIS despite longer processing compared to CT based thrombolysis. Methods: In Jan. 2009, we implemented CODE RED, a computerized stroke code, at our hospital with the aim of achieving rapid stroke assessment and treatment. We included patients with thrombolysis from January 2007 to December 2008 (pre-stroke code period) and those from January 2009 to May 2013 (post-stroke code period). The IV t-PA time intervals and 90 day modified Rankin scores (mRS) were collected. Results: During the observation period, 252 patients used IV t-PA under the CODE RED (MRI based-208, CT based-44). The remaining 71 patients (MRI based-53, CT based-18) did not. After implementation of CODE RED, door to image time, door to needle time, and the onset to needle time were significantly reduced by 11, 18, and 22 minutes in MRI based thrombolysis. Particularly, the proportion of favorable outcome (mRS 0-2) was significant increased (from 41.5 into 60.1%, p=0.02) in post- than in pre-stroke code period in MRI based thrombolysis. However, in ordinal regression, the presence of stroke code showed just a trend for favorable outcome (OR: 0.99-2.87, p=0.059) at 90 days of using IV t-PA after correction of age, sex, and NIHSS. Conclusions: In this study, we demonstrated that a systemized stroke code shortened time intervals for using IV t-PA under MRI screening. Also, our results showed a possibility that a systemized stroke code might enhance the efficacy of MRI based thrombolysis. In the future, we need to more detailed prospective study about this notion.
Author Disclosures: J. Cha: None. K. Eun-Kyu: None.
- © 2015 by American Heart Association, Inc.