Introduction: A prospective stroke database was implemented as part of a still-growing comprehensive stroke centre (CSC). This CSC is located within a referral public hospital (Hospital Occidente de Kennedy) in Bogota DC, Colombia , that serves 2.3 million people of mainly low economic income. In this abstract, we present the data pertaining patients who were thrombolysed in our institution during the first year of data collection, and specify onset-to-door (OTD) times as they relate to the means of transportation used. Hypothesis: Acute stroke patients who arrive in ambulance have the shortest onset-to-door times. Methods: Printed forms were filled for every patient who arrived with diagnosis of acute ischemic stroke (AIS) or transient ischemic attack (TIA). Data was transcribed to an electronic database (Numbers, Apple Inc.) and analyzed with SPSS Statistics version 23 (IBM Corporation). A retrospective descriptive analysis was performed for central tendency and dispersion measures. Results: Since August 1st 2014 until July 31st 2015, 39 patients (17.7% of AIS patients) were thrombolysed. Mean onset-to-door times are shown in table 1. Prenotification was received for only 1 patient. All patients came from their homes. Conclusions: Almost half of our thrombolysed patients arrived in taxi to our institution. Taxi was the fastest means of transportation, ambulance was the slowest and private cars were in the middle of those. This confirmed our suspicion that the state-owned emergency medical services (SEMD) are suboptimal and that stroke patients prefer to use public transportation rather than SEMD. This should warn public health authorities on he urgent need to improve our SEMD. In the meantime, this finding prompts us to include taxi drivers in our periodic stroke campaigns.
Introduction: A prospective stroke database was implemented as part of a still-growing comprehensive stroke centre (CSC). This CSC is located within a referral public hospital (Hospital Occidente de Kennedy) in Bogota DC, Colombia , and serves 2.3 million people of mainly low economic income. During the first 7 months of the CSC (Period 1: August 1st 2014 - March 1st 2015), the neurology-lead stroke team was available from 6 am to 6 pm. Stroke patients who arrived at night were treated by emergency physicians. After period 1, the stroke team was available 24/7 (Period 2, March 2nd 2015 - July 31st 2015). Hypothesis: The presence of a stroke team 24/7, increases the monthly rate of thrombolysed patients and of activated stroke codes. Methods: Printed forms were filled for every patient who arrived with diagnosis of acute ischemic stroke (AIS) or transient ischemic attack (TIA). Data was transcribed to an electronic database (Numbers, Apple Inc.) and analyzed with SPSS Statistics version 23 (IBM Corporation). Results: During the entire year, 104 stroke codes were assessed and 39 patients were thrombolysed; 26.3% of these occurred during night shift and 73.7% in day shift. Figures are depicted in table 1. During period 2, the probability of thrombolysis during night shift increased 2.2 times and the number of non-activated stroke codes was reduced by 14.1%. Therefore, in period 2 only one patient who was a candidate for IV rtPA did not receive treatment, whereas in period 1 this happened in 4 patients. Conclusions: In our experience, the availability of a 24/7 stroke team lead by neurology doubled the amount of patients thrombolysed at night and reduced the number of stroke codes that were not activated by emergency physicians. Counterintuitively, neither the rate of monthly thrombolysis nor that of stroke codes were modified in our case. However, the evaluated periods were short and our stroke network is still in its beginnings.
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