Reducing care time after implementing protocols for acute ischemic stroke: a systematic review.

Area of Science:

• Neurology
• Emergency Medicine
• Health Services Research

Background:

• Acute ischemic stroke treatment necessitates rapid intervention and symptom recognition.
• Cerebral reperfusion therapy is a critical component of acute ischemic stroke management.
• Timely care significantly impacts patient outcomes in stroke cases.

Purpose of the Study:

• To evaluate the effectiveness of acute ischemic stroke protocols in reducing patient care times.
• To analyze the impact of implementing standardized protocols on stroke treatment efficiency.
• To identify key time intervals affected by stroke protocol implementation.

Main Methods:

• Systematic review of primary studies published between 2011 and 2020.
• Inclusion of studies in Portuguese, English, and Spanish focusing on acute ischemic stroke.
• Data extraction and narrative synthesis by independent reviewers, with methodological quality assessment.

Main Results:

• Thirty-five studies were included out of 11,226 initial publications.
• Protocol implementation showed effectiveness in improving door-to-image, image-to-needle, and door-to-needle times.
• Limited improvement was noted in symptom-onset-to-door time; study population clarity was a limitation.

Conclusions:

• Protocol implementation has led to significant advances in in-hospital stroke care.
• Enhanced prehospital care and earlier symptom recognition are essential for optimizing stroke treatment.
• Further research is needed to address limitations in defining the study population for stroke protocol effectiveness.