Fibrinolysis in a District Hospital: Performance of the First Two Years

Abstract

Introduction: Fibrinolysis is a therapy of ischemic stroke and
its precocity relates to the prognosis. In this paper we analyzed the performance times in the first two years of the “code
stroke” rapid access protocol patients undergoing fibrinolysis.
Material and Methods: Prospective and observational study
with data from 1 July 2015 to 30 June 2017. We performed
descriptive analysis and inferential statistics. The analysis included the door-to-doctor time (since the hospital admission
to the clinical evaluation), the door-to-computed tomography
(CT) time (since the hospital admission to the CT scan completion) and the door-to-needle time (since the hospital admission to the fibrinolysis).
Results: Thirty-eight fibrinolysis were carried out. The inferential analysis revealed no statistically significant differences. The median of the door-to-doctor time (00h06m versus
00h07m) and door-to-CT time (00h32m versus 00h31m) were
similar in both years. The door-to-needle time has improved
in the second year (median 1h15m versus 00h52m).
Discussion: We have seen improvement in the door-to-needle
time in the second year, fulfilling, in most cases, the times
recommended by the National Institute of Neurological Disorders and Stroke. The door-to-CT time does not comply with
these recommendations in none of the years.
Conclusion: In the second year we improved the global performance. Measures will be adopted to reduce the door-toCT time