The Success of Stroke Fast Track at Bangkok Hospital Medical Center: 5 Years’ Experience

Abstract

OBJECTIVE: To study the outcomes of intravenous recombinant tissue plasminogen activator (rt-PA) therapy in acute ischemic stroke patients at Bangkok Hospital Medical Center (BMC). MATERIALS AND METHODS: A retrospective review was performed on acute ischemic stroke patients who arrived at the hospital within three hours of symptom onset and entered the stroke pathway, from 2008 to 2012. The success of the stroke fast track was determined using the National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI), and modiÀ ed Rankin Scale (mRS) scores. RESULTS: All 1,548 patients were enrolled in the stroke pathway at BMC from 2008 to 2012. There were 182 acute ischemic stroke patients who arrived at the hospital within 3 hours from the onset of symptoms, and 25 of them were eligible for intravenous rt-PA therapy. The patients who received rt-PA therapy demonstrated a signiÀ cant reduction in NIHSS and mRS scores, as well as a signiÀ cant increase in BI scores on the discharge day (p < 0.01). CONCLUSION: Our data suggests favorable clinical outcomes in acute ischemic stroke patients who received rt-PA therapy, as well as the success of the stroke pathway administration system at BMC.