Related factors of the delay of door-to-needle time in patients with acute ischemic stroke

Abstract

Objective To investigate the factors affecting the door-to-needle (DTN) time for intravenous thrombolytic therapy in patients with acute ischemic stroke. Methods Patients with acute ischemic stroke treated with intravenous thrombolysis were enrolled prospectively. The demography, vascular risk factors, and other clinical data were collected. According to DTN time 60 min as a standard, the patients were divided into either a non-delay group or a delay group. The factors affecting DTN delay were analyzed. Results A total of 78 patients with acute ischemic stroke treated with intravenous thrombolysis were enrolled, 46 (59.0%) were males with an average age of 64.24±10.06 years. The average National Institutes of Health Stroke Scale (NIHSS) score was 12.13±3.17. The average DTN time was 79.77±20.51 min, and the DTN time in 55 patients (70.51%) was >60 min. The age (66.3±9.7 years vs. 59.3±9.4 years; t=2.939, P=0.004), door-to-CT initiation time (32.7±11.3 min vs. 24.6±7.1 min ; t=3.183, P=0.002), door-to-CT interpretation time (50.8±16.8 min vs. 35.5±8.8 min; t=4.383, P<0.001), and door-to-biochemistry result time (62.6±11.0 min vs. 44.8±5.6 min; t=7.377, P<0.001) in the delay group were all significantly higher or longer than those in the non-delay group. The proportions of patients with hypertension (58.2% vs. 26.1%; χ2=6.687, P=0.010) and using antihypertensive drugs before onset (41.8% vs. 13.0%; χ2=6.043, P=0.014) in the delay group were also higher than those in the non-delay group. Multivariate logistic regression analysis showed that the door-to-biochemistry result time (odds ratio 1.725, 95% confidence interval 1.058-2.814; P=0.029) was an independent influencing factor for DTN delay. Conclusions The delay of door-to-biochemistry result time is an independent factor for DTN time delay in patients with acute ischemic stroke treated with intravenous thrombolytic therapy. Key words: Stroke; Brain Ischemia; Thrombolytic Therapy; Tissue Plasminogen Activator; Hospitalization; Risk Factors; Time Factors