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. 2023 Sep;44(9):3199-3207.
doi: 10.1007/s10072-023-06828-3. Epub 2023 May 6.

Bringing door-to-needle times within the European benchmarks results in better stroke patients outcomes in a spoke hospital from the Apulian Region

Maurizio Giorelli  1 , Ruggiero Leone  2 , Maria Stella Aniello  2 , Sergio Altomare  2 , Isabella Colonna  2 , Daniele Liuzzi  2 , Immacolata Plasmati  2 , Michele Sardaro  2 , Nicola Fioretto  3 , Giuseppe Di Paola  4 , Emanuele Tatò  5 , Alessandro Scelzi  6
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Bringing door-to-needle times within the European benchmarks results in better stroke patients outcomes in a spoke hospital from the Apulian Region

Maurizio Giorelli et al. Neurol Sci. 2023 Sep.

Abstract

Introduction: Door-to-needle time (DNT) is a key factor in acute stroke treatment success. We retrospectively analysed the effects of a new protocol aimed at reducing treatment delays in our single-centre observational series over a 1-year period (from October 1st 2021 to September 30th 2022).

Methods: The time frame was divided into two semesters as a new protocol was started at the beginning of the second semester to ensure a rapid evaluation, imaging, and intravenous thrombolysis in all stroke patients attending our spoke-hospital serving 200,000 inhabitants. Logistics and outcome measures were obtained for each patient and compared before and after implementation of the new protocol.

Results: A total of 215 patients with ischemic stroke attended our hospital within a 1-year period (109 in the first semester, 96 in the second semester). Seventeen percent and 21% of all patients underwent acute stroke thrombolysis in the first and second semesters, respectively. DNTs were strongly reduced in the second semester (from 90 to 55 min), bringing this value below the Italian and European benchmarks. This resulted in better short-term outcomes (an average of 20%) as measured by both Δ NIHSS scores at 24 h and at discharge with respect to baseline.

Keywords: DTIs (door-to-imaging times); DTNs (door-to-needle times); ITNs (imaging-to-needle times); NIHSS (National Institutes of Health Stroke Scale) scores; OTNs (onset-to-needle times); Stroke unit care.

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