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Emerg Med J 26:324-326 doi:10.1136/emj.2008.063610
  • Original Article

Intravenous thrombolysis for ischaemic stroke: short delays and high community-based treatment rates after organisational changes in a previously inexperienced centre

  1. A Tveiten1,
  2. Å Mygland1,3,4,
  3. U Ljøstad1,
  4. L Thomassen2
  1. 1
    Department of Neurology, Sørlandet Hospital Kristiansand, Norway
  2. 2
    Department of Neurology, Haukeland University Hospital, Bergen, Norway
  3. 3
    Institute of Clinical Medicine, University of Bergen, Bergen, Norway
  4. 4
    Hospital of Rehabilitation, Rikshospitalet University Hospital, Kristiansand, Norway
  1. Dr A Tveiten, Department of Neurology, Sorlandet Sykehus Kristiansand, 4604 Kristiansand, Norway; arnstein.tveiten{at}sshf.no
  • Accepted 30 September 2008

Abstract

Aim: To evaluate hospital delays in thrombolytic treatment before and after organisational changes and community-based treatment rates in a previously inexperienced centre.

Methods: The delays before and after organisational changes made in 2006 were compared using a prospective treatment database. In a 6-month period in 2007, a community-based search was performed for all hospitalisations for ischaemic stroke. The number of patients admitted within the 0–3 h time window and the proportion treated with tissue plasminogen activator were analysed.

Results: The number of treatments increased fourfold from 2005 to 2007 with a significant reduction in mean door-to-needle time from 60 min to 38 min (p = 0.002). In the community-based series, 14/137 patients (10%) hospitalised with ischaemic stroke and 13/32 patients (41%) admitted in the 0–3 h window were treated.

Conclusions: An inexperienced stroke centre can rapidly implement the necessary logistics to deliver thrombolysis to a large proportion of patients with acute stroke with short hospital delays. Important factors are probably prenotification of a team and the initiation of thrombolytic treatment in the emergency room.

Footnotes

  • Competing interests: AT and LT have received travel grants and honoraria from Boehringer Ingelheim GmbH.