Abstract
BackgroundReports have proven that shorter door-to-needle time (DTN time) indicates better outcomes in AIS patients received intravenous thrombolysis. Efforts have been made by hospitals and centers to minimize DTN time in many ways including introducing a stroke nurse. However, there are few studies to discuss the specific effect of stroke nurse on patients’ prognosis. This study aimed to compare consecutive AIS patients before and after the intervention to analyze the effect of stroke nurse on clinical outcome of AIS patients.MethodsIn this retrospective study, we observed 1003 patients from November 2016 to December 2020 dividing in two groups, collected and analyzed AIS patients’ medical history, clinical assessment information, important timelines, 90 mRS score, etc. Comparative analysis and mediation analysis were also used in this study.ResultsA total of 418 patients was included in this study, and 199 patients were enrolled in the stroke nurse group and 219 was in the preintervention group. Baseline characteristics of patients showed no significant difference except there seems more patients with previous ischemic stroke history in the group of stroke nurse. (p = 0.008). The median DTN time significantly decreased in the stroke nurse group (25 min versus 36 min, p < 0.001) and multivariate logistic regression analysis showed the 90-day mRS clinical outcome significantly improved in the stroke nurse group (p = 0.001). Mediation analysis indicated the reduction of DTN time plays a partial role on the 90 days mRS score and the stroke nurse has some direct effect on the improvement of clinical outcome (p = 0.006).ConclusionsThe introduction of stroke nurse is beneficial to clinical outcome of AIS patients and can be use of reference in other hospitals or centers.
Highlights
Reports have proven that shorter door-to-needle time (DTN time) indicates better outcomes in acute ischemic stroke (AIS) patients received intravenous thrombolysis
Ethics approval and consent to participate This study policy was explained detailly and verbal informed consent was obtained from each study patient or their family members, which was approved by the ethics committee of Nanjing First Hospital, Nanjing Medical University and conducted in full accordance with the World Medical Association Declaration of Helsinki. These 1003 patients with acute ischemic stroke are patients arriving within 4.5-hour thrombolysis time
The results show the intervention of stroke nurse significantly improved the 90 days modified Rankin Scale (mRS) score (p = 0.001)
Summary
Reports have proven that shorter door-to-needle time (DTN time) indicates better outcomes in AIS patients received intravenous thrombolysis. Intravenous thrombolysis (IVT) has been proven to be an effective way to help patients gain reperfusion and improve the clinical outcomes of ischemic stroke [5,6,7]. Door-to-needle time (DTN time) is defined as the time from hospital arrival to thrombolysis administration. It is a rather objective measurement of hospital management. Studies have shown that shorter DTN time was associated with lower disability, mortality and better outcomes [8, 9]
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