Effect of the changes of hospital diagnosis and treatment mode on the treatment time in patients with acute ischemic stroke
10.3969/j.issn.1672-5921.2015.12.001
- VernacularTitle:医院诊治模式的改变对急性缺血性卒中患者救治时间的影响
- Author:
Pengfei XING
;
Yongwei ZHANG
;
Lei CHEN
;
Xuan ZHU
;
Ping ZHANG
;
Xiongfeng WU
;
Benqiang DENG
;
Jianmin LIU
- Publication Type:Journal Article
- Keywords:
Stroke;
Acute ischemic stroke;
Physician′s practice patterns;
Door-to-needle time
- From:
Chinese Journal of Cerebrovascular Diseases
2015;(12):617-620
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the effect of the changes of hospital diagnosis and treatment mode on the treatment time in patients with acute ischemic stroke before and after the establishment of Cerebrovascular Disease Center. Methods A total of 103 consecutive patients with acute ischemic stroke admitted to the Department of Neurology,Changhai Hospital,the Second Military Medical University between June 2008 and December 2012 were enrolled retrospectively. Thirty-one of them were excluded because of incomplete medical records. Finally,72 patients were enrolled as a control group and received series diagnosis and treatment mode. A total of 210 consecutive patients with acute ischemic stroke admitted to the Cerebrovascular Disease Center,Changhai Hospital,the Second Military Medical University from September 2013 to February 2015 were enrolled retrospectively. Thirteen patients were excluded (4 patients with recurrent transient ischemic attack were treated with recombinant tissue-type plasminogen activator,9 without complete data were treated with intravenous thrombolysis),197 were enrolled as an observation group finally,and they were received series diagnosis and treatment mode. The patients of both groups were visited within 4. 5 h after onset and received rt-PA treatment. The time-consuming changes of each time period from onset-to-door,door-to-imaging,imaging-to-needle,door-to-needle,and onset-to-needle time between the control group and the observation group were compared and analyzed. Results Compared with the control group,the door-to-imaging,imaging-to-needle,door-to-needle and onset-to-needle time were significantly shorter in the observation group. There were significant difference between the 2 groups (24 ± 12 min vs. 60 ± 20 min,27 ± 12 min vs. 62 ± 31 min,51 ± 17 min vs. 122 ± 52 min,and 153 ± 69 min vs. 230 ± 81 min,all P < 0. 01). There was no significant difference for onset-to-door time between the observation group and the control group (P > 0. 05). Conclusion The establishment of cerebral vascular disease center and the improvement of the processes have shortened the treatment time in patients with acute ischemic stroke within time window. The time from onset-to-door is still longer,and the propaganda and education of stroke should be strengthened.
