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Abstract Details

Treatment within the Get with the Guidelines (GWTG) target of less than 45 minutes for intravenous thrombolysis improves 90 day outcome
Cerebrovascular Disease and Interventional Neurology
P3 - Poster Session 3 (5:30 PM-6:30 PM)
3-063

Evaluate the predictors of door to needle time (DNT) and its impact on outcome in a multicenter cohort.

Faster delivery of intravenous thrombolysis (IVT) in acute ischemic stroke leads to better outcomes. Recently, Get with the Guidelines (GWTG) suggested a benchmark door to needle time (DNT) of less than 45 minutes. We sought to evaluate the predictors of DNT and its impact on outcome in a multicenter cohort.

We retrospectively analyzed data of consecutive patients treated with intravenous tissue (IV) plasminogen activator (tPA) in a multicenter cohort. Demographic information, symptoms onset to emergency department arrival time (LKN to Door), door to needle time for tPA (DTN) and functional outcome at 90 days (mRS) were compared between patients with DTN < 45 minutes and >45 minutes. Multivariate logistic regression was used to determine factors independently associated with a favorable modified rankin scale (mRS) at 90 days.

A total of 85 patients were included in the study of which 32 (37.6%) patients received tPA within 45 minutes of arrival. Both groups (DTN < 45 minutes vs. DTN >45 minutes) were balanced for age (p=0.61), female gender (p=0.06), NIHSS (p=0.10) and LKN to Door (p=0.39). Using multivariate analysis, patients who received tPA <45 minutes of arrival were 4.6 times more likely to have a favorable outcome (mRS 0-2) at 90 days.
Earlier treatment with tPA (DTN <45 minutes) leads to better outcomes at 90 days. Our findings support the GWTG benchmark of DNT of less than 45 minutes
Authors/Disclosures
Abdallah M. Hamdallah, MD (Advocate Medical Group)
PRESENTER 		Dr. Hamdallah has nothing to disclose.
Muhib Khan, MD, FAAN (Mayo Clinic) The institution of Dr. Khan has received research support from Mayo Clinic 好色先生 Grant . The institution of Dr. Khan has received research support from Mayo Clinic Small Grants .
Tracy J. Koehler Tracy J. Koehler has nothing to disclose.
Daniel Sacchetti, DO, FAAN Dr. Sacchetti has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
Tamer Abdelhak, MD (Albany Medical College) Dr. Abdelhak has nothing to disclose.
Brian Silver, MD, FAAN (UMass Memorial Medical Center) Dr. Silver has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Various legal firms. Dr. Silver has received intellectual property interests from a discovery or technology relating to health care. Dr. Silver has received publishing royalties from a publication relating to health care. Dr. Silver has received publishing royalties from a publication relating to health care. Dr. Silver has received publishing royalties from a publication relating to health care. Dr. Silver has received personal compensation in the range of $500-$4,999 for serving as a Consultant with Women's Health Initiative. Dr. Silver has received personal compensation in the range of $500-$4,999 for serving as a Consultant with Best Doctors, Inc./Teladoc, Inc.. Dr. Silver has a non-compensated relationship as a Consultant with ABPN that is relevant to AAN interests or activities. Dr. Silver has a non-compensated relationship as a Member, Regional Board of Directors with American Heart Association that is relevant to AAN interests or activities.