Door To Needle Time In Acute Stroke

The door to needle time dnt the time from presentation of patient with symptoms at the hospital to the start of ivt can therefore be used to evaluate the quality of the acute stroke care provided by each hospital.

Door to needle time in acute stroke.

8 aha asa guidelines recommend the target for completion of initial evaluation and start of tpa treatment should be within 1 hour of the patient s arrival. The benefits of tpa in patients with acute ischemic stroke are time dependent and guidelines recommend a door to needle time. However fewer than one third of acute ischemic stroke patients who receive tpa are treated within guideline recommended door to needle times. A national institute of neurological disorders and stroke national symposium on the rapid identification and treatment of acute stroke recommended a door to needle target time of 60 minutes.

The benefits of intravenous tissue type plasminogen activator tpa in acute ischemic stroke are time dependent and guidelines recommend a door to needle time of 60 minutes. Question is there an association between shorter door to needle time with thrombolytic therapy and long term mortality and hospital readmission in patients with acute ischemic stroke. Every 15 minute increase in door to needle times after 60 minutes of hospital arrival was significantly associated with higher cardiovascular readmission secondary outcome adjusted hr 1 02 95 ci 1 01 1 04 and higher stroke readmission a post hoc secondary out come adjusted hr 1 02 95 ci 1 00 1 04. Lowering the median dnt is an essential goal for quality improvement and is therefore used worldwide in audits for this.

Stroke launched by the american heart association american stroke association in 2010 is a national quality improvement initiative focused on improving acute ischemic stroke care by reducing door to needle times for eligible patients being treated with tpa.