Impact of Emergency Department Transitions of Care on Thrombolytic Use in Acute Ischemic Stroke

Stroke.ahajournals.org: Olga P. Madej-Fermo, MD; Ilene Staff, PhD; Gil Fortunato, MBA; Lincoln Abbott, MD; Louise D. McCullough, MD, PhD, March 26, 2012.

Background and Purpose—In-hospital mortality is higher for certain medical conditions based on the time of presentation to the emergency department. The primary goal of this study was to determine whether patients with acute ischemic stroke who arrived to the emergency department during a nursing shift change had similar rates of thrombolytic use and functional outcomes compared with patients presenting during nonshift change hours.

Methods—A retrospective review of patients with acute ischemic stroke presenting to the emergency department of a primary stroke center from 2005 through 2010. The time to notify the stroke team, perform a head CT scan, and to start intravenous or intra-arterial thrombolysis was assessed. Thrombolysis rates, mortality rate, discharge disposition, change in the National Institutes of Health Stroke Scale, and change in modified Barthel Index at 3 and 12 months were assessed. Read More