Implementation of a wake-up and unknown symptom onset stroke protocol

B. Jennings, E. Creel, D. Lee, G. Vidal
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Abstract

Background: Establishing a symptom onset timeline for stroke patients is one of the essential aspects of thrombolytic therapy. Implementing an MRI protocol can potentially increase the rate of thrombolytic therapy and expand treatment to patients who would otherwise be excluded.Objective: This project aimed to increase the rate of thrombolytic therapy by incorporating an additional layer of evaluation within the established acute stroke code process for patients with wake-up stroke (WUS) or unknown symptom onset stroke.Methods: Patients 18 years of age and older who presented as WUS eligible for thrombolytic therapy underwent acute MRI. Patients with a diffusion weighted image and fluid attenuated inversion recovery mismatch (DWI-FLAIR Mismatch) on MRI were treated with thrombolytic therapy.Results: Chi-square test of independence showed patients who underwent the MRI protocol (N = 35) had a higher proportion of alteplase (tissue plasminogen activator,tPA) treatment when compared to a similar sample (N = 44) from 2019 acute stoke logs; ꭓ2 (1, N = 79) = 8.16, p = .006. Six patients received thrombolytic. Safety showed no symptomatic intracerebral hemorrhage (sICH) or deaths.
唤醒和未知症状发作中风方案的实施
背景:为脑卒中患者建立症状发作时间表是溶栓治疗的重要方面之一。实施核磁共振成像方案可以潜在地提高溶栓治疗的率,并扩大治疗范围,否则将被排除在外的患者。目的:本项目旨在通过在已建立的急性卒中编码过程中对醒脑(WUS)或未知症状发作的卒中患者纳入额外的评估层来提高溶栓治疗的率。方法:18岁及以上的WUS符合溶栓治疗条件的患者进行急性MRI检查。在MRI上出现扩散加权图像和液体衰减反转恢复失配(DWI-FLAIR失配)的患者接受溶栓治疗。结果:独立性卡方检验显示,与2019年急性卒中日志中的类似样本(N = 44)相比,接受MRI方案的患者(N = 35)接受阿替普酶(组织纤溶酶原激活剂,tPA)治疗的比例更高;ꭓ2 (1,N = 79) = 8.16, p = 0.006。6例患者接受溶栓治疗。安全性显示无症状性脑出血(sICH)或死亡。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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