Time Barriers to Receiving Recombinant Tissue Plasminogen Activator in Patients with Acute Ischemic Stroke
DOI:
https://doi.org/10.52547/uiemj.1.1.40Keywords:
Acute ischemic stroke, tissue plasminogen activator, rtPA, timelineAbstract
Objective: This study aimed to evaluate the barriers and limitations of receiving recombinant tissue plasminogen activator (rtPA) in patients with acute ischemic stroke.
Methods: The present study is a cross-sectional study that was performed on 188 patients with ischemic stroke who were referred for rtPA treatment. Patient records were quarried for demographic information and timelines of events from onset of symptoms and Emergency Department referral to rtPA treatment invitation. Patients were divided into groups of rtPA receiving group and the non-rtPA group. Collected data were analyzed by SPSS 20 software.
Results: The mean age of patients was 67.28±12.55 years. Meantime to emergency physician visit (P=0.2), the average time to neurologist visit (P = 0.3), the average time to CT scan (P=0.08), and average time to CT scan interpretation (P = 0.4) had no statistically significant difference between the rtPA receiving group and the non- rtPA group. But the average time from the onset of symptoms to reaching the emergency room (P = 0.001), the average time until the patient was assigned to a neurologist (P = 0.05), the average time from the emergency physician visit to the first instruction by the nurse (P = 0.02), the average time to blood test preparation (P = 0.001) and mean NIHSS score (P = 0.005) in the rtPA group were significantly lower than the non-rtPA group.
Conclusion: According to the findings, delay in referring patients to medical centers is the most important obstacle to not receiving rtPA. There are also several inhibitory factors from the time of entering the emergency room to receiving rtPA, but all of these factors can be intervened based on further researches.
Ethics approval and consent to participate:
The study was approved by the Institutional Review Board of Mashhad University of Medical Sciences.
Consent For Publication:
Not Applicable.
Availability of Data and Materials:
All data are available in the article.
Competing interests:
None.
Funding:
Mashhad University of Medical Sciences.
Authors' contributions:
MF and RG designed the study. EP and RG quarried patient records for assessing timelines. The manuscript was written by EP and RG and revised by MF.
Acknowledgments
The authors are grateful for the cooperation of Ghaem Hospital, affiliated with the Vice Chancellor for Research of Mashhad University of Medical Sciences.
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