Shortening door-to-puncture time and improving patient outcome with workfow optimization in patients with acute ischemic stroke associated with large vessel occlusion
Dublin Core
Title
Shortening door-to-puncture time and improving patient outcome with workfow optimization in patients with acute ischemic stroke associated with large vessel occlusion
Subject
Door-to-puncture time, Door-to-recanalization time, Puncture-to-recanalization time, Ischemic stroke,
Endovascular therapy, Workfow optimization
Endovascular therapy, Workfow optimization
Description
Objective: We aimed to evaluate door-to-puncture time (DPT) and door-to-recanalization time (DRT) without directing healthcare by neuro-interventionalist support in the emergency department (ED) by workfow optimization and
improving patients’ outcomes.
Methods: Records of 98 consecutive ischemic stroke patients who had undergone endovascular therapy (EVT)
between 2018 to 2021 were retrospectively reviewed in a single-center study. Patients were divided into three groups:
pre-intervention (2018–2019), interim-intervention (2020), and post-intervention (January 1st 2021 to August 16th,
2021). We compared door-to-puncture time, door-to-recanalization time (DRT), puncture-to-recanalization time (PRT),
last known normal time to-puncture time (LKNPT), and patient outcomes (measured by 3 months modifed Rankin
Scale) between three groups using descriptive statistics.
Results: Our fndings indicate that process optimization measures could shorten DPT, DRT, PRT, and LKNPT. Median
LKNPT was shortened by 70 min from 325 to 255 min(P<0.05), and DPT was shortened by 119 min from 237 to
118 min. DRT shortened by 132 min from 338 to 206 min, and PRT shortened by 33 min from 92 to 59 min from the
pre-intervention to post-intervention groups (all P<0.05). Only 21.4% of patients had a favorable outcome in the preintervention group as compared to 55.6% in the interventional group (P=0.026).
Conclusion: This study demonstrated that multidisciplinary cooperation was associated with shortened DPT, DRT,
PRT, and LKNPT despite challenges posed to the healthcare system such as the COVID-19 pandemic. These practice
paradigms may be transported to other stroke centers and healthcare providers to improve endovascular time metrics and patient outcomes.
improving patients’ outcomes.
Methods: Records of 98 consecutive ischemic stroke patients who had undergone endovascular therapy (EVT)
between 2018 to 2021 were retrospectively reviewed in a single-center study. Patients were divided into three groups:
pre-intervention (2018–2019), interim-intervention (2020), and post-intervention (January 1st 2021 to August 16th,
2021). We compared door-to-puncture time, door-to-recanalization time (DRT), puncture-to-recanalization time (PRT),
last known normal time to-puncture time (LKNPT), and patient outcomes (measured by 3 months modifed Rankin
Scale) between three groups using descriptive statistics.
Results: Our fndings indicate that process optimization measures could shorten DPT, DRT, PRT, and LKNPT. Median
LKNPT was shortened by 70 min from 325 to 255 min(P<0.05), and DPT was shortened by 119 min from 237 to
118 min. DRT shortened by 132 min from 338 to 206 min, and PRT shortened by 33 min from 92 to 59 min from the
pre-intervention to post-intervention groups (all P<0.05). Only 21.4% of patients had a favorable outcome in the preintervention group as compared to 55.6% in the interventional group (P=0.026).
Conclusion: This study demonstrated that multidisciplinary cooperation was associated with shortened DPT, DRT,
PRT, and LKNPT despite challenges posed to the healthcare system such as the COVID-19 pandemic. These practice
paradigms may be transported to other stroke centers and healthcare providers to improve endovascular time metrics and patient outcomes.
Creator
Shuiquan Yang, Weiping Yao, James E. Siegler, Mohammad Mofatteh, Jack Wellington, Jiale Wu, Wenjun Liang, Gan Chen, Zhou Huang, Rongshen Yang, Juanmei Chen, Yajie Yang, Zhaohui Hu and Yimin Chen
Publisher
BMC Emergency Medicine
Date
(2022) 22:136
Contributor
Fajar bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Shuiquan Yang, Weiping Yao, James E. Siegler, Mohammad Mofatteh, Jack Wellington, Jiale Wu, Wenjun Liang, Gan Chen, Zhou Huang, Rongshen Yang, Juanmei Chen, Yajie Yang, Zhaohui Hu and Yimin Chen, “Shortening door-to-puncture time and improving patient outcome with workfow optimization in patients with acute ischemic stroke associated with large vessel occlusion,” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/4237.