Effects of the Improvement of rt-PA Administration Process and Stroke Fast Track System of Saraburi hospital
Keywords:
Ischemic Stroke, Recombinant tissue plasminogen activator (rt-PA), National Institute of Health Stroke Scale, Barthel Index, Modified Rankin ScaleAbstract
Objective: To study the outcomes after the improvement of the stroke fast track system of Saraburi Hospital through the assessment of Thailand quality indicators of standard stroke care, complications, mortality rate, NIHSS, modified Rankin Scale, and Barthel index.
Subjects: The subjects were 143 ischemic stroke patients treated with rt-PA from February 2018 – March 2020 at Saraburi Hospital. The subjects were divided into 2 groups: 53 patients before improvement (group 1) and 90 patients after improvement (group 2).
Method: This research was retrospectively reviewed demographic data, Thailand quality indicators of standard stroke care, complication, mortality, NIHSS, mRS, and Barthel index. The results were analyzed using t-test, Mann-Whitney U test, and Chi square. Results: After improving the system, the average times of the stages in the process i.e. door to physician, door to lab, door to lab interpretation, door to CT initiation, door to CT interpretation, and door to needle time reduced to 1.48 , 5.89 ,14.84 ,4.32, 11.87, and 39.23 minutes, respectively, with statistically significant difference in group 1 and 2. Death occurred in 7 patients (13.2%), and 12 patients (13.3%), respectively. There was no statistically significant difference in mortality, complication, NIHSS, mRS, and Barthel index.
Conclusion: After the improvement of the system, all indicators of the stroke service plan were improved with statistically significant difference. However, complications, mortality and NIHSS, mRS and Barthel index were not significantly different between two groups.
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