Helsinki model cut stroke thrombolysis delays to 25 minutes in Melbourne in only 4 months

Meretoja, Atte; Weir, Louise; Ugalde, Melissa; Yassi, Nawaf; Yan, Bernard; Hand, Peter J.; Truesdale, Melinda; Davis, Stephen M.; Campbell, Bruce C.V.

doi:10.1212/wnl.0b013e3182a4a4d2

Cited by 260 publications

(237 citation statements)

References 16 publications

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“…A study in Melbourne recently showed the rapid transferability of the Helsinki thrombolysis model, achieving a 25-minute interval within 8 months of changing protocol. 25 Improving in-hospital processes is feasible because they are controlled by a relatively small number of people. Canada has made progress in this regard in the last decade.…”

Section: Cmaj Openmentioning

confidence: 99%

The quality of treatment of hyperacute ischemic stroke in Canada: a retrospective chart audit

et al. 2014

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Section: Cmaj Openmentioning

confidence: 99%

The quality of treatment of hyperacute ischemic stroke in Canada: a retrospective chart audit

et al. 2014

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“…Previous studies have shown that the treatment performed by neurology experts and the implementation of simple measures reduced the DNT 4,5,10,15 . In the current study, not only we were able to implement similar measures throughout the study's period, but we also provided patients admitted in the TB group with an additional simple measure, an exclusive bed for IVT treatment.…”

Section: Gabriella Tansini Et Al Bed For Thrombolysis Reduces Door-tmentioning

confidence: 99%

“…These analyses were similar to a previously reported study 3 . Throughout the study's period, neurologists were responsible for coordinating the teams and similar measures compared to those done by previous studies were done during all the study period 4,5,10 . During the study period, a total of 150 ischemic stroke patients were admitted following EMS evaluation and were submitted to IVT; 71 (47.3%) were admitted in the first period of the study and composed the ER Group, whereas the other 79 (52.7%) were admitted in the second part of the study and composed the TB Group.…”

Section: In-hospital Patient's Flowmentioning

confidence: 99%

“…Current guidelines suggest that DNT should be lower than 60 minutes, but only 26% of patients achieve this goal 2 . The implementation of simple measures allowed more patients to be treated within the first hour after admission 3,4,5 . The aim of this study was to analyze whether the inclusion of an exclusive thrombolytic bed (TB) could reduce DNT in a general hospital.…”

mentioning

confidence: 99%

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Exclusive bed for thrombolysis. A simple measure that allows 85% of ischemic stroke patients to be treated in the first hour

Tansini

Ducci

Nóvak

et al. 2016

Arq. Neuro-Psiquiatr.

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ARTICLEExclusive bed for thrombolysis. A simple measure that allows 85% of ischemic stroke patients to be treated in the first hour Leito exclusivo para trombólise. Uma medida simples que permite que 85% dos pacientes com acidente vascular cerebral sejam tratados na primeira hora Gabriella Tansini, Renata Dal-Prá Ducci, Edison Matos Nóvak, Francisco Manoel Branco Germiniani, Viviane Flumignan Zétola, Marcos Christiano Lange The outcome of patients submitted to intravenous thrombolysis (IVT) is directly related to the onset-to-needle time and one of the most important goals to reduce the time to treatment is a short door-to-needle time (DNT) 1. Current guidelines suggest that DNT should be lower than 60 minutes, but only 26% of patients achieve this goal 2 . The implementation of simple measures allowed more patients to be treated within the first hour after admission 3,4,5 . The aim of this study was to analyze whether the inclusion of an exclusive thrombolytic bed (TB) could reduce DNT in a general hospital. METHODThis was an interventional analysis study in which patients evaluated in the first period (pre-intervention; i.e. prior to the implementation of the TB) were compared with the post-intervention group and were used as historical controls. The study subjects were patients admitted with ischemic stroke who were submitted to IVT within 4.5 hours after onset of symptoms between November 2010 and June 2013. There was no formal calculation on the number of patients needed to include in the study, as the structural and AbsTrACTThe door-to-needle time is an important goal to reduce the time to treatment in intravenous thrombolysis. Objective: Analyze if the inclusion of an exclusive thrombolytic bed reduces the door-to-needle time. Method: One hundred and fifty patients admitted for neurological evaluation with ischemic stroke were separated in two groups: in the first, patients were admitted in the Emergency Room for intravenous thrombolysis (ER Group); in the second, patients were admitted in an exclusive thrombolytic bed in the general neurology ward (TB Group). Results: Sixty-eight (86.0%) patients from TB Group were treated in the first 60 minutes of arrival as compared to 48 (67.6%) in the ER Group (p = 0.011). Conclusion: The introduction of a thrombolytic bed in a general hospital setting can markedly reduce the door-to-needle time, allowing more than 85% of patients to be treated within the first hour of admission.Keywords: neurology; stroke; treatment; thrombolytic therapy. rEsuMO A redução no tempo porta-agulha é um objetivo importante para diminuir o tempo de tratamento na trombólise endovenosa. Objetivo: Analisar se a inclusão de um leito exclusivo de trombólise reduz o tempo porta-agulha. Método: Cento e cinqüenta pacientes admitidos com acidente vascular cerebral isquêmico foram separados em dois grupos: no primeiro, os pacientes foram admitidos no Pronto-Atendimento para trombólise endovenosa (Grupo PA); no segundo, os pacientes foram admitidos no leito de trombólise na enfermaria de neuro...

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“…18 This model was replicated at the Royal Melbourne Hospital, where median door-to-needle times were reduced from 61 minutes to 25 minutes. 19 Improvements in the United States (US) have been reported by the Target-Stroke initiative. 20,21 Importantly, these improvements in door-to-needle treatment time have not resulted in an increase in complications.…”

mentioning

confidence: 99%

Good is not Good Enough: The Benchmark Stroke Door-to-Needle Time Should be 30 Minutes

Kamal

Benavente

Boyle

et al. 2014

Can. J. Neurol. Sci.

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Helsinki model cut stroke thrombolysis delays to 25 minutes in Melbourne in only 4 months

Cited by 260 publications

References 16 publications

The quality of treatment of hyperacute ischemic stroke in Canada: a retrospective chart audit

The quality of treatment of hyperacute ischemic stroke in Canada: a retrospective chart audit

Exclusive bed for thrombolysis. A simple measure that allows 85% of ischemic stroke patients to be treated in the first hour

Good is not Good Enough: The Benchmark Stroke Door-to-Needle Time Should be 30 Minutes

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