کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5963974 1576134 2016 4 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Reducing time delays in the management of ischemic stroke patients in Northern Italy
ترجمه فارسی عنوان
کاهش تاخیر زمانی در مدیریت بیماران مبتلا به سکته مغزی ایسکمیک در شمال ایتالیا
کلمات کلیدی
تاخیر قابل اجتناب، مدیریت سکته مغزی، ترومبولیزیسم،
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
چکیده انگلیسی

Background and purposeThrombolysis represents the best therapy for ischemic stroke but the main limitation of its administration is time. The avoidable delay is a concept reflecting the effectiveness of management pathway. For this reason, we projected a study concerning the detection of main delays with following introduction of corrective factors. In this paper we describe the results after these corrections.Materials and methodsConsecutive patients admitted for ischemic stroke during a 3-months period to 35 hospitals of a macro-area of Northern Italy were enrolled. Each time of management was registered, identifying three main intervals: pre-hospital, in-hospital and total times. Previous corrective interventions were: 1.increasing of population awareness to use the Emergency Medical Service (EMS); 2.pre-notification of Emergency Department; 3.use of high urgency codes; 4.use of standardised operational algorithm. Statistical analysis was conducted using time-to-event analysis and Cox proportional hazard regression.Results1084 patients were enrolled. EMS was alerted for 56.3% of subjects, mainly in females and severe strokes (p < 0.001). Thrombolytic treatment was performed in 4.7% of patients. Median pre-hospital and in-hospital times were 113 and 105 min, while total time was 240. High urgency codes at transport contributed to reduce pre-hospital and in-hospital time (p < 0.05). EMS use and high urgency codes promoted thrombolysis. Treatment within 4.5 hours from symptom onset was performed in 14% of patients more than the first phase of study.ConclusionsThe implementation of an organizational system based on EMS and concomitant high urgency codes use was effective to reduce avoidable delay and to increase thrombolysis.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: International Journal of Cardiology - Volume 215, 15 July 2016, Pages 431-434
نویسندگان
, , , , , , , , , , ,