Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Apr;22(4):243-248.
doi: 10.4103/ijccm.IJCCM_504_17.

Impact of "Stroke Code"-Rapid Response Team: An Attempt to Improve Intravenous Thrombolysis Rate and to Shorten Door-to-Needle Time in Acute Ischemic Stroke

Sushma K Gurav  1 , Kapil G Zirpe  1 , R S Wadia  2   3 , Avinash Naniwadekar  4 , Prajakta U Pote  1 , Amit Tungenwar  5 , Abhijeet M Deshmukh  1 , Srikanta Mohopatra  6 , Balakrishna Nimavat  1 , Prasad Surywanshi  1
Affiliations

Impact of "Stroke Code"-Rapid Response Team: An Attempt to Improve Intravenous Thrombolysis Rate and to Shorten Door-to-Needle Time in Acute Ischemic Stroke

Sushma K Gurav et al. Indian J Crit Care Med. 2018 Apr.

Abstract

Objective: "Stroke code" (SC) implementation in hospitals can improve the rate of thrombolysis and the timeline in care of stroke patient.

Materials and methods: A prospective data of patients treated for acute ischemic stroke (AIS) after implementation of "SC" (post-SC era) were analyzed (2015-2016) and compared with the retrospective data of patients treated in the "pre-SC era." Parameters such as symptom-to-door, door-to-physician, door-to-imaging, door-to-needle (DTN), and symptom-to-needle time were calculated. The severity of stroke was calculated using the National Institutes of Health Stroke Score (NIHSS) before and after treatment.

Results: Patients presented with stroke symptoms in pre- and post-SC era (695 vs. 610) and, out of these, patients who came in window period constituted 148 (21%) and 210 (34%), respectively. Patients thrombolyzed in pre- and post-SC era were 44 (29.7%) and 65 (44.52%), respectively. Average DTN time was 104.95 min in pre-SC era and reduced to 67.28 min (P < 0.001) post-SC implementation. Percentage of patients thrombolyzed within DTN time ≤60 min in pre-SC era and SC era was 15.90% and 55.38%, respectively.

Conclusion: Implementation of SC helped us to increase thrombolysis rate in AIS and decrease DTN time.

Keywords: Acute ischemic stroke; door to needle time; stroke code.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of parameters of stroke patients used for analysis in our study
Figure 2
Figure 2
Flowchart for screening stroke patient data in pre- and poststroke code era
See this image and copyright information in PMC

References

    1. Paramasivam S. Current trends in the management of acute ischemic stroke. Neurol India. 2015;63:665–72. - PubMed
    1. Kalkonde YV, Deshmukh MD, Sahane V, Puthran J, Kakarmath S, Agavane V, et al. Stroke is the leading cause of death in rural Gadchiroli, India: A Prospective community-based study. Stroke. 2015;46:1764–8. - PubMed
    1. Murthy JM. Thrombolysis for stroke in India: Miles to go. Neurol India. 2007;55:3–5. - PubMed
    1. Pandian JD, Sudhan P. Stroke epidemiology and stroke care services in India. J Stroke. 2013;15:128–34. - PMC - PubMed
    1. Truelsen T, Begg S, Mathers C. The Global Burden of Cerebrovascular Disease. [Last accessed on 2017 Aug]. Available from: http://www.WHO statistics:cerebrovascular disease stroke pdf .

LinkOut - more resources