Abstract TP400: Examining Five Year Trends of Documented Tissue Plasminogen Activator Contraindications in Wisconsin
Background: Target: Stroke was initiated in 2010 as a national quality improvement effort. This American Stroke Association campaign gave tools, consulting and data analysis to hospitals to improve door to needle time with tissue plasminogen activator (tPA). Along with this effort, the state of Wisconsin continued to work on a stroke system of care as well as education on tPA warnings versus absolute contraindications.
Methods: This study looked at an average of 40 Wisconsin hospitals and 26,185 ischemic stroke patients in Get With The Guidelines- Stroke over a five year period to determine if there were trends in how hospitals documented contraindications for tPA.
Results: From 2010 to 2014 Advanced Age and Age >80 decreased as a tPA contraindication by 7.3% and 4.6% respectively. Rapid Improvement decreased from 38% of the tPA contraindications to 35.1% over this time period. Hospitals also listed a 2.5% increase in the amount of patients receiving tPA in an outside hospital before transfer.
Conclusions: Through efforts such as Target: Stroke, statewide education and systems of care work, Wisconsin hospitals have improved the door to needle time for eligible patients from 18.1% in 2010 to 66.8% under 60 minutes. The data shows that advanced age is not used as often as a contraindication assuming education of age being a warning and not an absolute contraindication has had some effect on treatment decisions. It can also be assumed that referral hospitals are giving more tPA and transferring when necessary as hospitals have increased listing tPA at an outside hospital as a contraindication. Rapid Improvement has fluctuated but is at a five year low
Author Disclosures: M. Scharnott: None. K. Miller: None. D. Bluma: None. L. Serdynski: None.
- © 2016 by American Heart Association, Inc.