[Importance of the forewarning system and assistance center selection in acute stroke]

Acute ischemic stroke (AIS) is a time-dependent emergency, since the greatest impact depends on the time elapsed to treatment. The objective of this work was to analyze door to needle (DTN) and start treatment (STT) times and the effect of pre-notification system (PNS) and the appropriate choice of the healthcare center on these variables. An observational study with data obtained from records of patients admitted to the Stroke Unit (SU) was conducted between August 2015 to December 2019. We analyzed the number of intravenous thrombolytic treatments (IVT), DTN and STT and compared them according to PNS use, direct arrival at the center with SU or arrival at another center for subsequent referral. An overall of 472 patients were hospitalized during the studied period and the treatment was performed in 143 out of 265 patients. One hundred thirty-seven patients arrived from another center, 70 received IVT. Average DNT with PNS and without PNS were 41 ± 23 and 81 ± 44 minutes, respectively (p = 0.001). STT on direct arrival to SU was 159 ± 59 minutes and to another center for referral was 199 ± 44 (p = 0.001). The use of a PNS and the direct choice of a center where IVT is performed significantly improve treatment.