A RETROSPECTIVE STUDY ON IN-HOSPITAL DELAY FACTORS INFLUENCING INTRAVENOUS THROMBOLYSIS IN ACUTE ISCHEMIC STROKE PATIENTS FROM A TERTIARY CARE HOSPITAL IN NORTH EAST INDIA.
Rupjyoti Das, Aparajita Barman, Manash Ghose, Nomal Chandra Borah, Ananya Barman, Purabi Sarkar, Sneha Gang- General Medicine
- Applied Mathematics
- General Mathematics
- General Medicine
- General Chemistry
- Pulmonary and Respiratory Medicine
- Pediatrics, Perinatology, and Child Health
- Microbiology
- Immunology
- General Medicine
- General Medicine
- Pharmacology (medical)
- General Medicine
Objective: Reports on the inverse relation between onset-to-door (OTD) and door-to-needle (DTN) in stroke thrombolysis have been repeatedly reported. The current study aimed to explore the association between DTN with the outcome and multi-component interventions inuencing DTN to understand better why some patients get IVT in >60 mins DTN time. Methods: Twenty-ve consecutive AIS patients treated with rt-PA in the Department of Neurology from January 2019 to December 2022 admitted to our tertiary care hospital were included in this analysis. The patients were grouped into a delay group (door-to-needle time (DTN) > 60 minutes; n=11) or a non-delay group (DTN time< 60 minutes; n= 14). The baseline data, laboratory tests, onset-to-door (OTD) time, door-to-imaging time (DTI), and decision-making time in both groups were retrieved. Multivariate logistic analysis was performed to analyze the data. Results: There were signicant differences in hypertension, coronary artery disease, admission National Institutes of Health Stroke Scale (NIHSS), the Door to Imaging (DCT), Door to Needle (DTN), and decision-making time (DMT) between the two groups (all P<0.05). Multivariate logistic regression analysis revealed that the in-hospital delay was closely related to mRS score, OTD time, DCTtime, DMT, and hypertension (p<0.001). Conclusion:The study reects that the lesser the door-to-needle time and the sooner the treatment of thrombolysis to stroke patients, the better the clinical outcomes and recovery of the patients