Validation of hyperacute stroke protocol modification aiming for time saving

Abstract

AbstractBackground and purposeSince efforts to save time in hyperacute cerebral infarction largely depend on each facility, evaluation of their effects is indispensable. The effects of modification of the protocol for hyperacute stroke were examined.Materials and methodsThe data of consecutive stroke patients who underwent thrombectomy from October 2017 to February 2020 were retrospectively reviewed. The stroke protocols before modification were as follows. First, brain MRI was performed, and the indication for thrombectomy was assessed. If indicated, the stroke treatment team sprang into action to obtain informed consent and prepare the needed drugs or devices. The modified protocols were as follows. Once the information was obtained from emergency transportation, preparation for examination began before the patients' arrival. The patient quickly underwent contrast‐enhanced brain CT after arrival. If indicated, thrombolysis was started immediately, and the stroke treatment team began thrombectomy preparation. The cohort was dichotomized according to the period, the first term group and the second term group, and the time courses and outcomes were examined.ResultsA total of 33 patients (21 men, median age 76 years) were enrolled in the study, of whom 12 were in the second term group. Regarding the elapsed times, door to imaging, door to thrombolysis, door to puncture, and onset to reperfusion times were significantly shorter in the second term group.ConclusionThe protocol modification in our facility provided time savings.