减少识别小中风导致Door-to-Needle更长时间(P6.051)

文摘

摘要目的:评价door-to-needle (DTN)和组件次轻微中风。背景:短DTN将带来更好的结果。国家增加tPA卷可能部分由于增加轻微中风的治疗,但治疗时间在这个小组还没有得到深入研究。方法:我们回顾了所有ED患者接到7/2011-7/2015 tPA。我们人口相比,EMS使用,敬请原谅小中风之间的利率和DTN署≤5)和所有其他人。DTN组件相比,我们还专门neurologist-dependent时刻,中风激活(SA) tpa imaging-to-tPA, ED-dependent倍、door-to-SA door-to-imaging。通过配对t意味着比较,通过曼Whitney U,中位数和二分变量通过卡方测试。结果:311名患者接受tPA;126 (41 [percnt])是小中风。没有语言的差异(48 vs 52 [percnt]英语,p = 0.6)或性(39 vs 34 (percnt)男,p = 0.3)比其他小中风。 Minor strokes were younger (62 vs 73 years, p<0.01), less likely to use EMS (55 vs 80[percnt], p<0.01), and less likely to receive pre-notification by EMS (43 vs 71[percnt], p<0.01). DTN was longer in minor strokes (61 vs 55 min, p=0.01). For DTN components, door-to-SA (5 vs 2 min, p<0.01) and door-to-imaging (27 vs 21 min, p<0.01) were longer in minor strokes while imaging-to-tPA (33 vs 32 min, p=1.0) and SA-to-tPA (50 vs 51 min, p=0.5) were not. In the subgroup arriving by EMS, these differences persisted although they were no longer significant (DTN 59 vs. 54 min p=0.4; door-to-SA 4 vs. 1 min, p=0.05; door-to-imaging 25 vs. 20 min, p=0.05). Conclusion: We found longer DTN in minor strokes. Our data suggests that minor strokes were not recognized as quickly by EMS and at ED presentation. Efforts are needed to improve early recognition of minor strokes.

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