The Effectiveness of Thrombolytic Drug for Acute Ischemic Stroke Patients in the Stroke Fast Track System at Nakhon Phanom Stroke network

Abstract

Objective:
To assess treatment processes, clinical outcomes among acute ischemic stroke patients receiving thrombolysis within a stroke fast-track system in the Nakhon Phanom network.

Methods:
A retrospective descriptive study included 565 patients treated with intravenous thrombolysis at Nakhon Phanom Hospital, node, and the MSU between April 1, 2022 and April 30, 2025. Data were obtained from medical records using purposive sampling. Descriptive statistics summarized baseline characteristics. Independent t-tests compared time metrics and outcomes. Multiple logistic regression was used to identify predictors of favorable outcomes and complications.

Results:
The MSU significantly reduced Door-to-Needle Time (DNT) and Onset-to-Needle Time (OTN), while Nakhon Phanom Hospital and the MSU achieved shorter Door-to-CT Time (DT-CT) than network hospitals. No significant differences were found in symptomatic intracranial hemorrhage (sICH) or asymptomatic intracranial hemorrhage (aICH) (p = .390). At 24 hours, the mean NIHSS score was 8.17 ± 9.85. Favorable functional outcomes at 3 months were observed in 58.45% of patients. Cardioembolic stroke was the most common etiology (40.16%). The mean length of stay was 5.42 ± 6.44 days.
Conclusions:
The MSU effectively reduces treatment delays without increasing hemorrhagic risk. Integration of MSU into stroke fast-track systems may improve clinical outcomes and reduce long-term disability.