NDLI: Relationship between onset-to-door time and door-to-thrombolysis time: a pooled analysis of 10 dedicated stroke centers.

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Relationship between onset-to-door time and door-to-thrombolysis time: a pooled analysis of 10 dedicated stroke centers.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Gumbinger, Christoph Chamorro, Angel Parkkila, Anna-Kaisa Jung, Simon Gensicke, Henrik Mattle, Heinrich P. Seiffge, David J. Eskandari, Ashraf Ringleb, Peter Numminen, Heikki Strbian, Daniel Köhrmann, Martin Hacke, Werner Tiainen, Marjaana Obach, Victor Breuer, Lorenz Tatlisumak, Turgut Leys, Didier Weder, Bruno Engelter, Stefan T. Michel, Patrik Bodenant, Marie
Spatial Coverage	Europe
Description	Author Affiliation: Strbian D ( From the Department of Neurology and Stroke Unit, Helsinki University Central Hospital, Helsinki, Finland (D.S., M.T., T.T.))
Abstract	BACKGROUND AND PURPOSE: Inverse relationship between onset-to-door time (ODT) and door-to-needle time (DNT) in stroke thrombolysis was reported from various registries. We analyzed this relationship and other determinants of DNT in dedicated stroke centers. METHODS: Prospectively collected data of consecutive ischemic stroke patients from 10 centers who received IV thrombolysis within 4.5 hours from symptom onset were merged (n=7106). DNT was analyzed as a function of demographic and prehospital variables using regression analyses, and change over time was considered. RESULTS: In 6348 eligible patients with known treatment delays, median DNT was 42 minutes and kept decreasing steeply every year (P<0.001). Median DNT of 55 minutes was observed in patients with ODT ≤30 minutes, whereas it declined for patients presenting within the last 30 minutes of the 3-hour time window (median, 33 minutes) and of the 4.5-hour time window (20 minutes). For ODT within the first 30 minutes of the extended time window (181-210 minutes), DNT increased to 42 minutes. DNT was stable for ODT for 30 to 150 minutes (40-45 minutes). We found a weak inverse overall correlation between ODT and DNT (R(2)=-0.12; P<0.001), but it was strong in patients treated between 3 and 4.5 hours (R(2)=-0.75; P<0.001). ODT was independently inversely associated with DNT (P<0.001) in regression analysis. Octogenarians and women tended to have longer DNT. CONCLUSIONS: DNT was decreasing steeply over the last years in dedicated stroke centers; however, significant oscillations of in-hospital treatment delays occurred at both ends of the time window. This suggests that further improvements can be achieved, particularly in the elderly.
ISSN	00392499
e-ISSN	15244628
Journal	Stroke
Issue Number	10
Volume Number	44
Language	English
Publisher	Lippincott Williams & Wilkins (on behalf of the American Heart Association)
Publisher Date	2013-10-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Delivery Of Health Care Hospitalization Hospitals, Special Stroke Therapy Thrombolytic Therapy Sex Factors Time Factors Clinical Trial Multicenter Study Discipline Cardiology
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine Neuroscience Advanced and Specialized Nursing Neurology (clinical)

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