Cargando…

A rapid response-type doctor car system shortened time to intravenous thrombolytic therapy for patients with ischemic stroke: an observational study at a single emergency center in Japan

BACKGROUND: For patients with ischemic stroke, rapid reperfusion therapy is extremely important. In April 2015, our medical center introduced a rapid response-type doctor car (RRC) system. Here, an emergency medical team, including a physician, is dispatched to the patient’s prehospital location. Th...

Descripción completa

Detalles Bibliográficos
Autores principales: Yoshioka, Yuki, Gamo, Mina, Yoneda, Ryuhei, Matsunaga, Naoki, Takada, Tadaaki, Fukuta, Yasushi, Sato, Koichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318409/
https://www.ncbi.nlm.nih.gov/pubmed/32586264
http://dx.doi.org/10.1186/s12245-020-00292-y
_version_ 1783550844477636608
author Yoshioka, Yuki
Gamo, Mina
Yoneda, Ryuhei
Matsunaga, Naoki
Takada, Tadaaki
Fukuta, Yasushi
Sato, Koichi
author_facet Yoshioka, Yuki
Gamo, Mina
Yoneda, Ryuhei
Matsunaga, Naoki
Takada, Tadaaki
Fukuta, Yasushi
Sato, Koichi
author_sort Yoshioka, Yuki
collection PubMed
description BACKGROUND: For patients with ischemic stroke, rapid reperfusion therapy is extremely important. In April 2015, our medical center introduced a rapid response-type doctor car (RRC) system. Here, an emergency medical team, including a physician, is dispatched to the patient’s prehospital location. The team then assesses the patient and, if necessary, initiates infusion therapy, excluding thrombolytic therapy. Before arriving at the hospital, a prehospital physician orders the preparation of diagnostic tools and conducts an early consultation to a neurologist in order to begin thrombolytic therapy more swiftly. This study aimed to determine whether the RRC system shortened the time to commence intravenous reperfusion therapy in patients with ischemic stroke. This was a retrospective observational study conducted at a tertiary emergency center in Japan. Cases of patients with ischemic stroke who underwent intravenous thrombolytic therapy from January 2015 to December 2018 were enrolled. They were divided into two groups: RRC group (intervened by RRC system) and non-RRC group (not intervened by RRC system). The groups’ door-to-needle (DTN) time was compared. RESULTS: During the study period, 140 patients received intravenous thrombolytic therapy. Among those, 28 were in the RRC group and 28 received the usual prehospital care. Of 56 patients, the median age was 82 years old, and 42.9% of patients were male. The median NIHSS was 14 (IQR 10–21). As for demographics, there were no significant differences between the two groups. Median DTN time was 67 min (IQR 55–79) in RRC group vs. 81 min (IQR 69–107) in usual care group, respectively (P < 0.05). CONCLUSION: In this study, patients with ischemic stroke in RRC group received intravenous thrombolytic therapy in a shorter time compared to the group that received usual care.
format Online
Article
Text
id pubmed-7318409
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Springer Berlin Heidelberg
record_format MEDLINE/PubMed
spelling pubmed-73184092020-06-29 A rapid response-type doctor car system shortened time to intravenous thrombolytic therapy for patients with ischemic stroke: an observational study at a single emergency center in Japan Yoshioka, Yuki Gamo, Mina Yoneda, Ryuhei Matsunaga, Naoki Takada, Tadaaki Fukuta, Yasushi Sato, Koichi Int J Emerg Med Original Research BACKGROUND: For patients with ischemic stroke, rapid reperfusion therapy is extremely important. In April 2015, our medical center introduced a rapid response-type doctor car (RRC) system. Here, an emergency medical team, including a physician, is dispatched to the patient’s prehospital location. The team then assesses the patient and, if necessary, initiates infusion therapy, excluding thrombolytic therapy. Before arriving at the hospital, a prehospital physician orders the preparation of diagnostic tools and conducts an early consultation to a neurologist in order to begin thrombolytic therapy more swiftly. This study aimed to determine whether the RRC system shortened the time to commence intravenous reperfusion therapy in patients with ischemic stroke. This was a retrospective observational study conducted at a tertiary emergency center in Japan. Cases of patients with ischemic stroke who underwent intravenous thrombolytic therapy from January 2015 to December 2018 were enrolled. They were divided into two groups: RRC group (intervened by RRC system) and non-RRC group (not intervened by RRC system). The groups’ door-to-needle (DTN) time was compared. RESULTS: During the study period, 140 patients received intravenous thrombolytic therapy. Among those, 28 were in the RRC group and 28 received the usual prehospital care. Of 56 patients, the median age was 82 years old, and 42.9% of patients were male. The median NIHSS was 14 (IQR 10–21). As for demographics, there were no significant differences between the two groups. Median DTN time was 67 min (IQR 55–79) in RRC group vs. 81 min (IQR 69–107) in usual care group, respectively (P < 0.05). CONCLUSION: In this study, patients with ischemic stroke in RRC group received intravenous thrombolytic therapy in a shorter time compared to the group that received usual care. Springer Berlin Heidelberg 2020-06-26 /pmc/articles/PMC7318409/ /pubmed/32586264 http://dx.doi.org/10.1186/s12245-020-00292-y Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Original Research
Yoshioka, Yuki
Gamo, Mina
Yoneda, Ryuhei
Matsunaga, Naoki
Takada, Tadaaki
Fukuta, Yasushi
Sato, Koichi
A rapid response-type doctor car system shortened time to intravenous thrombolytic therapy for patients with ischemic stroke: an observational study at a single emergency center in Japan
title A rapid response-type doctor car system shortened time to intravenous thrombolytic therapy for patients with ischemic stroke: an observational study at a single emergency center in Japan
title_full A rapid response-type doctor car system shortened time to intravenous thrombolytic therapy for patients with ischemic stroke: an observational study at a single emergency center in Japan
title_fullStr A rapid response-type doctor car system shortened time to intravenous thrombolytic therapy for patients with ischemic stroke: an observational study at a single emergency center in Japan
title_full_unstemmed A rapid response-type doctor car system shortened time to intravenous thrombolytic therapy for patients with ischemic stroke: an observational study at a single emergency center in Japan
title_short A rapid response-type doctor car system shortened time to intravenous thrombolytic therapy for patients with ischemic stroke: an observational study at a single emergency center in Japan
title_sort rapid response-type doctor car system shortened time to intravenous thrombolytic therapy for patients with ischemic stroke: an observational study at a single emergency center in japan
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318409/
https://www.ncbi.nlm.nih.gov/pubmed/32586264
http://dx.doi.org/10.1186/s12245-020-00292-y
work_keys_str_mv AT yoshiokayuki arapidresponsetypedoctorcarsystemshortenedtimetointravenousthrombolytictherapyforpatientswithischemicstrokeanobservationalstudyatasingleemergencycenterinjapan
AT gamomina arapidresponsetypedoctorcarsystemshortenedtimetointravenousthrombolytictherapyforpatientswithischemicstrokeanobservationalstudyatasingleemergencycenterinjapan
AT yonedaryuhei arapidresponsetypedoctorcarsystemshortenedtimetointravenousthrombolytictherapyforpatientswithischemicstrokeanobservationalstudyatasingleemergencycenterinjapan
AT matsunaganaoki arapidresponsetypedoctorcarsystemshortenedtimetointravenousthrombolytictherapyforpatientswithischemicstrokeanobservationalstudyatasingleemergencycenterinjapan
AT takadatadaaki arapidresponsetypedoctorcarsystemshortenedtimetointravenousthrombolytictherapyforpatientswithischemicstrokeanobservationalstudyatasingleemergencycenterinjapan
AT fukutayasushi arapidresponsetypedoctorcarsystemshortenedtimetointravenousthrombolytictherapyforpatientswithischemicstrokeanobservationalstudyatasingleemergencycenterinjapan
AT satokoichi arapidresponsetypedoctorcarsystemshortenedtimetointravenousthrombolytictherapyforpatientswithischemicstrokeanobservationalstudyatasingleemergencycenterinjapan
AT yoshiokayuki rapidresponsetypedoctorcarsystemshortenedtimetointravenousthrombolytictherapyforpatientswithischemicstrokeanobservationalstudyatasingleemergencycenterinjapan
AT gamomina rapidresponsetypedoctorcarsystemshortenedtimetointravenousthrombolytictherapyforpatientswithischemicstrokeanobservationalstudyatasingleemergencycenterinjapan
AT yonedaryuhei rapidresponsetypedoctorcarsystemshortenedtimetointravenousthrombolytictherapyforpatientswithischemicstrokeanobservationalstudyatasingleemergencycenterinjapan
AT matsunaganaoki rapidresponsetypedoctorcarsystemshortenedtimetointravenousthrombolytictherapyforpatientswithischemicstrokeanobservationalstudyatasingleemergencycenterinjapan
AT takadatadaaki rapidresponsetypedoctorcarsystemshortenedtimetointravenousthrombolytictherapyforpatientswithischemicstrokeanobservationalstudyatasingleemergencycenterinjapan
AT fukutayasushi rapidresponsetypedoctorcarsystemshortenedtimetointravenousthrombolytictherapyforpatientswithischemicstrokeanobservationalstudyatasingleemergencycenterinjapan
AT satokoichi rapidresponsetypedoctorcarsystemshortenedtimetointravenousthrombolytictherapyforpatientswithischemicstrokeanobservationalstudyatasingleemergencycenterinjapan