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Implementing a Stroke Alert Team (SAT) significantly reduced delays in acute stroke thrombolysis, improving patient outcomes. This multidisciplinary approach enhanced both intravenous thrombolysis (IVT) and intra-arterial thrombectomy (IAT) times.

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Area of Science:

  • Emergency Medicine
  • Neurology
  • Clinical Quality Improvement

Background:

  • Acute stroke treatment requires rapid thrombolysis (IVT and IAT) to minimize morbidity and mortality.
  • In-hospital delays in administering thrombolysis remain a critical challenge.
  • A 24/7 multidisciplinary approach is essential for optimizing acute stroke care.

Purpose of the Study:

  • To decrease in-hospital delays for both intravenous thrombolysis (IVT) and intra-arterial thrombectomy (IAT).
  • To implement and evaluate a multidisciplinary Stroke Alert Team (SAT) for 24/7 acute stroke management.
  • To improve thrombolysis rates and reduce post-thrombolysis complications.

Main Methods:

  • Implementation of a Stroke Alert Team (SAT) involving hospital-initiated ambulance prenotification and reorganized in-hospital processes.
  • Comparative analysis of patient characteristics, evaluation/thrombolysis times, thrombolysis rates, and post-thrombolysis intracranial hemorrhage before and after SAT implementation.
  • Data collected from January 2014 to August 2016.

Main Results:

  • Median door-to-CT, door-to-MRI, and door-to-laboratory times significantly decreased post-SAT.
  • Median door-to-IVT time reduced from 46 to 20.5 minutes; median door-to-IAT time reduced from 156 to 86.5 minutes.
  • Thrombolysis rate increased from 9.8% to 15.8%, while post-thrombolysis intracranial hemorrhage rate decreased from 12.6% to 2.1%.

Conclusions:

  • The Stroke Alert Team (SAT) effectively decreased in-hospital delays for acute stroke thrombolysis.
  • SAT implementation led to a significant increase in thrombolysis rates and a reduction in post-thrombolysis intracranial hemorrhage.
  • The observed time benefits of SAT were consistent for both IVT and IAT, irrespective of time of day.