- 作者：Lee A. Birnbaum ; MD ; MS* ; &dagger ; ; &Dagger ; ; birnbaum@uthscsa.edu" class="auth_mail" title="E-mail the corresponding author ; Jesse S. Rodriguez ; PhD* ; &Dagger ; ; Christopher H. Topel ; MD&dagger ; ; &Dagger ; ; Reza Behrouz ; MD&dagger ; ; Vivek Misra ; MD&dagger ; ; Santiago Palacio ; MD&dagger ; ; Michele G. Patterson ; MSN&Dagger ; ; Deb S. Motz ; BSN&Dagger ; ; Martin W. Goros ; MS§ ; ; John E. Cornell ; PhD§ ; ; Jean-Louis R. Caron ; MD* ; &dagger ; ; &Dagger ;
- 关键词：Acute ischemic stroke ; stroke treatment ; antithrombotic ; tissue plasminogen activator
- 刊名：Journal of Stroke and Cerebrovascular Diseases
- 出版年：2016
- 出版时间：November 2016
- 年：2016
- 卷：25
- 期：11
- 页码：2668-2672
- 全文大小：218 K
Methods
A retrospective review of our Get With The Guidelines database was performed for a 5-hospital telestroke network for the period between January 2010 and January 2015. All acute ischemic stroke patients who were triaged in the emergency departments connected to the telestroke network and received IV t-PA were included. Optimal DTN time was defined as less than 60 minutes. Logistic regression was performed with clinical variables associated with DTN time. Age and National Institutes of Health Stroke Scale (NIHSS) score were categorized based on clinically significant cutoffs.
Results
Six-hundred and fifty-two patients (51% women, 46% White, 45% Hispanic, and 8% Black) were included in this study. The mean age was 70 years (range 29-98). Of the variables analyzed, only arrival mode, initial NIHSS score, and the interaction between age and initial NIHSS score were significant. DTN time more than or equal to 60 minutes was most common in patients aged more than 80 years with NIHSS score higher than 10.
Conclusions
The cause of DTN time delay for older patients with higher NIHSS score is unclear but was not related to presenting blood pressure or arrival mode. Further study of this subgroup is important to reduce overall DTN times.