Stroke
Conditions
Keywords
inhospital delays, door-to-needle time, thrombolysis, acute ischemic stroke, SITS, SITS-WATCH, stroke registry
Brief summary
In patients with acute ischemic stroke: the sooner the thrombolysis treatment is administered after symptom onset - the better the outcome. This delay can be dissected into onset-to-door time and door-to-needle time (DNT). SITS-WATCH aims to reduce median DNT in participating centres.
Detailed description
In patients with acute ischemic stroke: the sooner the thrombolysis treatment is administered after symptom onset - the better the outcome. This delay can be dissected into onset-to-door time and door-to-needle time (DNT). Of the two, DNT can be directly influenced within the hospital by stream-lining of acute stroke care. The aim of our study is to reduce in-hospital delays (DNT) in self-selecting centers recruiting patients into the the Safe Implementation of Treatments in Stroke-International Stroke Thrombolysis Register (SITS-ISTR) , comprising currently more than 80 000 patients from 1338 centers. Current median of DNT in all SITS centers is 65 minutes (compared with 20 minutes in Helsinki Univer-sity Central Hospital). An itemized detailed questionnaire, including all factors known to influence DNT, has been sent to all SITS centers to identify the reasons for long in-hospital delays. Based on the replies, we have prepared a list of interventions that can be considered by individual SITS centers in order to reduce DNT with interventions that are in line with national legislation.
Interventions
OTHERReduction of DTN
15-item list of suggested interventions aiming to reduce DNT sent to SITS-WATCH centers.
Sponsors
SITS International
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All consecutive patients with acute ischemic stroke registered in SITS registry.
Exclusion criteria
* Centers not inputing patient data into SITS registry. Patients with missing DNT data.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Absolute DNT reduction of at least 20 minutes or at least 20% change in SITS-WATCH centers that completed the whole study period | January 2013-December 2014 | DNT will be evaluated at regular intervals (twice a year). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Significantly larger reduction of DNT in SITS-WATCH centers compared with non-SITS-WATCH centers in SITS. | 2014-2015 | Proportion of centers with median DNT below 40 minutes. At least 3 new interventions implemented. Percentage of implemented interventions. |
Countries
Sweden
Contacts
Primary ContactNils Wahlgren, Prof.
Backup ContactDaniel Strbian, Dr.
Outcome results
None listed