Abstract
Objectives: To investigate the therapeutic process and golden times for treating stroke patients receiving thrombolytic therapy at Imam Reza Hospital in Tabriz.
Design: A cross-sectional descriptive study.
Setting(s): The information for all patients entering the study was extracted from the stroke registry of the Neurosciences Research Center.
Participants: Participants comprised all patients who were referred to Imam Reza Hospital emergency department (ED) in 2018, hospitalized as stroke patients, and had an indication for receiving thrombolytic therapy.
Outcome measures: Data included demographic information, length of stay in the ED, time interval from the onset of symptom to ED arrival, time to CT scan, time to the start of thrombolytic therapy, outcomes (e.g., discharge, hospitalization, or death), and the use of tissue plasminogen activator (tPA) therapy.
Results: A total of 140 patients were studied, with a mean and median age of 66.19±12.68 and 67.5 years, respectively. The mode age was 73 years, with the maximum age being 91 years and the minimum age being 34 years. Moreover, 82 (58.6%) of patients were male, and 58 (41.4%) were female. The mean time interval from ED arrival to the start of thrombolytic injection was 54.49±27.42 minutes, with a median and mode of 51 and 60 minutes, respectively. The minimum time was 17 minutes, and the maximum time was 218 minutes. The modified ranking scale (mRS) score at 7 days was significantly related to the National Institutes of Health Stroke Scale (NIHSS) at arrival, NIHSS 36 hours after treatment, NIHSS at 7 days after treatment, the incidence of intracerebral hemorrhage, and hospitalization duration (P≤0.001).
Conclusions: Initiating thrombolytic injection within 60 minutes is feasible, and patients’ status 7 days after discharge has a significant relationship with NIHSS at arrival, NIHSS 36 hours post-treatment, and NIHSS 7 days post-treatment. Moreover, there is a significant correlation between mRS at 7 days and an interval of less than 60 minutes from ED arrival to the start of thrombolytic injection. In such cases, mRS is lower.