Prenotification for thrombolysis before admission shortens door-to-needle time for patients with acute ischemic stroke

Ying WANG; Ya WU; Qiuju ZHAO; Xue MA; Wei LI

doi:10.16016/j.1000-5404.201801237

您当前的位置：

首页 >

文章列表页 >

Prenotification for thrombolysis before admission shortens door-to-needle time for patients with acute ischemic stroke

更新时间：2026-01-09

- Prenotification for thrombolysis before admission shortens door-to-needle time for patients with acute ischemic stroke
- Journal of Third Military Medical University Vol. 40, Issue 16, Pages: 1523-封3(2018)
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.201801237
  CLC：
- Received：30 January 2018，
  
  Published：30 August 2018
- 稿件说明：
移动端阅览
Ying WANG, Ya WU, Qiuju ZHAO, et al. Prenotification for thrombolysis before admission shortens door-to-needle time for patients with acute ischemic stroke[J]. Journal of Third Military Medical University, 2018, 40(16): 1523-封3.
DOI：

Ying WANG, Ya WU, Qiuju ZHAO, et al. Prenotification for thrombolysis before admission shortens door-to-needle time for patients with acute ischemic stroke[J]. Journal of Third Military Medical University, 2018, 40(16): 1523-封3. DOI： 10.16016/j.1000-5404.201801237.

摘要

Abstract

Objective

To evaluate the effect of prenotification before admission for thrombolysis in shortening the door-to-needle time (DNT) and on the outcomes of patients with acute ischemic stroke.

Methods

This retrospective analysis was conducted based on the data of 115 patients with acute ischemic stroke receiving intravenous thrombolytic treatment in our stroke center between June

2016 and June

2017.The difference in the DNT was analyzed between patients with prenotification for thrombolysis before admission (

=40) and those without prenotification (

=75).The onset-to-needle time (ONT)

National Institutes of Health Stroke Scale (NHISS) score at discharge

the rate of good prognosis (mRS score 0 to 2) and the mortality rate at 90 days were also re

corded and analyzed.

Results

The ONT was slightly longer in the prenotification group than in the group without prenotificaiton (207.00±89.71

175.11±65.21 min

=0.031)

but the DNT was significantly shorter in the prenotification group (42.57±19.58

59.55±13.95 min

0.01).No significant difference was found between the 2 groups in NHISS scores at discharge

the rate of good prognosis or the mortality rate at 90 d (

0.05).Compared with the patients without prenotificaiton

the patients with prenotification had significantly shorter door-to-imaging time (

0.05) and the interval from the imaging report to consent by the patients' relatives to thrombolysis (

0.01).The duration of the imaging examination and the time from consent to thrombolysis to the start of thrombolysis therapy were similar between the 2 groups (

0.05).

Conclusion

Prenotification for thrombolysis before admission can shorten the DNT for patients with acute ischemic stroke.In the primary care centers where thrombolytic therapy is not accessible

prenotification of the hospital to which the patient is to be transferred can be essential.

关键词

Keywords

references

中华医学会神经病学分会中华医学会神经病学分会脑血管病学组中国急性缺血性脑卒中诊治指南2014 中华神经科杂志 2015 48 4 246 257 10.3760/cma.j.issn.1006-7876.2015.04.002 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志, 2015, 48(4):246-257.DOI:10.3760/cma.j.issn.1006-7876.2015.04.002.

Neurology Branch of Chinese Medical Association Neurology Branch of Chinese Medical Association cerebrovascular Diseases Study Group Guide to diagnosis and treatment of acute ischemic stroke in China 2014 Chin J Neurol 2015 48 4 246 257 10.3760/cma.j.issn.1006-7876.2015.04.002 Neurology Branch of Chinese Medical Association, Neurology Branch of Chinese Medical Association cerebrovascular Diseases Study Group.Guide to diagnosis and treatment of acute ischemic stroke in China 2014[J].Chin J Neurol, 2015, 48(4):246-257.DOI:10.3760/cma.j.issn.1006-7876.2015.04.002.

重组组织型纤溶酶原激活剂治疗缺血性卒中共识专家组重组组织型纤溶酶原激活剂静脉溶栓治疗缺血性卒中中国专家共识(2012版) 中华内科杂志 2012 51 12 1006 1010 重组组织型纤溶酶原激活剂治疗缺血性卒中共识专家组.重组组织型纤溶酶原激活剂静脉溶栓治疗缺血性卒中中国专家共识(2012版)[J].中华内科杂志, 2012, 51(12):1006-1010.

Recombinant Tissue Plasminogen Activatort Reats Acute Ischemic Stroke Consensus Expert Group The Chinese expert consensus on recombinant tissue plasminogen activator intravenous thrombolytic therapy for ischemic stroke (2012 Ed) Chin J Intern Med 2012 51 12 1006 1010 10.3760/cma.j.issn.0578-1426.2012.12.022 Recombinant Tissue Plasminogen Activatort Reats Acute Ischemic Stroke Consensus Expert Group.The Chinese expert consensus on recombinant tissue plasminogen activator intravenous thrombolytic therapy for ischemic stroke (2012 Ed)[J].Chin J Intern Med, 2012, 51(12):1006-1010.DOI:10.3760/cma.j.issn.0578-1426.2012.12.022.

HACKE W KASTE M BLUHMKI E Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke N Engl J Med 2008 359 13 1317 1329 10.1056/NEJMoa0804656 HACKE W, KASTE M, BLUHMKI E, et al .Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke[J ] . N Engl J Med, 2008, 359(13):1317-1329.DOI:10.1056/NEJMoa0804656.

HACKE W DONNAN G FIESCHI C Association of outcome with early stroke treatment:pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials Lancet 2004 363 9411 768 774 10.1016/S0140-6736(04)15692-4 HACKE W, DONNAN G, FIESCHI C, et al .Association of outcome with early stroke treatment:pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials[J ] . Lancet, 2004, 363(9411):768-774.DOI:10.1016/S0140-6736(04)15692-4.

ALCOCK S SAWATZKY J V "Time is Brain:" A concept anaiysis Can J Neurosci Nurs 2016 38 2 5 11 http://www.ncbi.nlm.nih.gov/pubmed/17313125 ALCOCK S, SAWATZKY J V."Time is Brain:" A concept anaiysis[J]. Can J Neurosci Nurs, 2016, 38(2):5-11.

POWERS W J DERDEYN C P BILLER J 2015 American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment:a guideline for healthcare professionals from the American Heart Association/American Stroke Association Stroke 2015 46 10 3020 3035 10.1161/STR.0000000000000074 POWERS W J, DERDEYN C P, BILLER J, et al .2015 American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment:a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J ] . Stroke, 2015, 46(10):3020-3035.DOI:10.1161/STR.0000000000000074.

GOYAL M DEMCHUK A M MENON B K Randomized assessment of rapid endovascular treatment of ischemic stroke N Engl J Med 2015 372 11 1019 1030 10.1056/NEJMoa1414905 GOYAL M, DEMCHUK A M, MENON B K, et al .Randomized assessment of rapid endovascular treatment of ischemic stroke[J ] . N Engl J Med, 2015, 372(11):1019-1030.DOI:10.1056/NEJMoa1414905.

DEMCHUK A M GOYAL M MENON B K Endovascular treatment for small core and anterior circulation proximal occlusion with emphasis on minimizing CT to recanalization times (ESCAPE) trial:methodology Int J Stroke 2015 10 3 429 438 10.1111/ijs.12424 DEMCHUK A M, GOYAL M, MENON B K, et al .Endovascular treatment for small core and anterior circulation proximal occlusion with emphasis on minimizing CT to recanalization times (ESCAPE) trial:methodology[J ] . Int J Stroke, 2015, 10(3):429-438.DOI:10.1111/ijs.12424.

KHATRI P YEATTS S D MAZIGHI M Time to angiographic reperfusion and clinical outcome after acute ischaemic stroke:an analysis of data from the Interventional Management of Stroke (IMS Ⅲ) phase 3 trial Lancet Neurol 2014 13 6 567 574 10.1016/S1474-4422(14)70066-3 KHATRI P, YEATTS S D, MAZIGHI M, et al .Time to angiographic reperfusion and clinical outcome after acute ischaemic stroke:an analysis of data from the Interventional Management of Stroke (IMS Ⅲ) p hase 3 trial[J ] . Lancet Neurol, 2014, 13(6):567-574.DOI:10.1016/S1474-4422(14)70066-3.

CAMPBELL B C HILL M D RUBIERA M Safety and efficacy of solitaire stent thrombectomy:individual patient data meta-analysis of randomized trials Stroke 2016 47 3 798 806 10.1161/STROKEAHA.115.012360 CAMPBELL B C, HILL M D, RUBIERA M, et al .Safety and efficacy of solitaire stent thrombectomy:individual patient data meta-analysis of randomized trials[J ] . Stroke, 2016, 47(3):798-806.DOI:10.1161/STROKEAHA.115.012360.

FONAROW G C ZHAO X SMITH E E 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 16 1632 1640 10.1001/jama.2014.3203 FONAROW G C, ZHAO X, SMITH E E, et al .Door-to-needle times for tissue plasminogen activator administration and clinical o utcomes in acute ischemic stroke before and after a quality improvement initiative[J ] . JAMA, 2014, 311(16):1632-1640.DOI:10.1001/jama.2014.3203.

EBINGER M WINTER B WENDT M Effect of the use of ambulance-based thrombolysis on time to thrombolysis in acute ischemic stroke:a randomized clinical trial JAMA 2014 311 16 1622 1631 10.1001/jama.2014.2850 EBINGER M, WINTER B, WENDT M, et al .Effect of the use of ambulance-based thrombolysis on time to thrombolysis in acute ischemic stroke:a randomized clinical trial[J ] . JAMA, 2014, 311(16):1622-1631.DOI:10.1001/jama.2014.2850.

FAKHRALDEEN M SEGAL E DE CHAMPLAIN F Effect of the use of ambulance-based thrombolysis on time to thrombolysis in acute ischemic stroke:a randomized clinical trial CJEM 2015 17 6 709 712 10.1017/cem.2014.65 FAKHRALDEEN M, SEGAL E, DE CHAMPLAIN F.Effect of the use of ambulance-based thrombolysis on time to thrombolysis in acute ischemic stroke:a randomized clinical trial[J]. CJEM, 2015, 17(6):709-712.DOI:10.1017/cem.2014.65.

WOLTERS F J PAUL N L LI L Sustained impact of UK FAST-test public education on response to stroke:a population-based time-series study Int J Stroke 2015 10 7 1108 1114 10.1111/ijs.12484 WOLTERS F J, PAUL N L, LI L, et al .Sustained impact of UK FAST-test public education on response to stroke:a population-based time-series study[J ] . Int J Stroke, 2015, 10(7):1108-1114.DOI:10.1111/ijs.12484.

OLASCOAGA A A FREIJO G M M FERNáNDEZ M C Use of emergency medical transport and impact on time to care in patients with ischaemic stroke Neurologia 2017 10.1016/j.nrl.2016.11.004 OLASCOAGA A A, FREIJO G M M, FERNáNDEZ M C, et al .Use of emergency medical transport and impact on time to care in patients with ischaemic stroke[J ] . Neurologia, 2017, DOI:10.1016/j.nrl.2016.11.004.

SAUSER K LEVINE D A NICKLES A V Hospital variation in thrombolysis times among patients with acute ischemic stroke:the contributions of door-to-imaging time and imaging-to-needle time JAMA Neurol 2014 71 9 1155 1161 10.1001/jamaneurol.2014.1528 SAUSER K, LEVINE D A, NICKLES A V, et al .Hospital variation in thrombolysis times among patients with acute ischemic stroke:the contributions of door-to-imaging time and imaging-to-needle time[J ] . JAMA Neurol, 2014, 71(9):1155-1161.DOI:10.1001/jamaneurol.2014.1528.

急性缺血性卒中静脉溶栓: 中国卒中学会科学声明 [J ] . 实用心脑肺血管病杂志 , 2017 , 25 ( 10 ): 58 . 急性缺血性卒中静脉溶栓: 中国卒中学会科学声明[J]. 实用心脑肺血管病杂志, 2017, 25(10): 58.

Intravenous thrombolysis for acute ischemic stroke: Chinese Stroke Association scientific statement [J ] . Prac J Cardiac Cerebral Pneumal Vasc Dis , 2017 , 25 ( 10 ): 58 . Intravenous thrombolysis for acute ischemic stroke: Chinese Stroke Association scientific statement[J]. Prac J Cardiac Cerebral Pneumal Vasc Dis, 2017, 25(10): 58.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Risk factors for stroke-associated pneumonia after endovasular treatment in acute anterior circulation ischemic stroke patients

Efficacy of endovascular treatment for acute ischemic stroke with large core infarction and its influencing factors

Influencing factors of PH2 intracranial hemorrhage after endovascular treatment in acute ischemic stroke: analysis of 64 cases

Related Author

Wenjie ZI

Qingwu YANG

ZHANG Xiaoge

WANG Yu

QIN Yujie

ZUO Meng

CAI Zhengwei

GAO Yang

Related Institution

Department of Neurology, Second Affiliated Hospital, Army Medical University (Third Military Medical University)

Department of Neurology， First Affiliated Hospital， Army Medical University （Third Military Medical University）

Chongqing Center for Disease Control and Prevention

Department of Neurology, Daping Hospital, Army Medical University (Third Military Medical University)

Department of Neurology, First Affiliated Hospital, Army Medical University (Third Military Medical University)

⁰