Title Positive impact of the participation in the ENCHANTED trial in reducing Door-to-Needle Time
Authors Yang, Jie
Wang, Xia
Yu, Jian Ping
Hang, Jing
Lavados, Pablo
Robinson, Thompson
Arima, Hisatomi
Lindley, Richard I.
Anderson, Craig S.
Chalmers, John
Affiliation Chengdu Med Coll, Dept Neurol, Affiliated Hosp 14, Chengdu, Sichuan, Peoples R China.
Univ New South Wales, George Inst Global Hlth, Fac Med, Sydney, NSW, Australia.
Nanjing Med Univ, Nanjing Hosp 1, Dept Neurol, Nanjing, Jiangsu, Peoples R China.
Univ Desarrollo, Clin Alemana, Dept Med, Serv Neurol, Santiago, Chile.
Univ Chile, Santiago, Chile.
Univ Leicester, Dept Cardiovasc Sci, Leicester, Leics, England.
Univ Leicester, NIHR Biomed Res Ctr, Leicester, Leics, England.
Fukuoka Univ, Dept Publ Hlth, Fukuoka, Japan.
Peking Univ, Hlth Sci Ctr, George Inst Global Hlth, Beijing, Peoples R China.
Chengdu Med Coll, Dept Neurol, Affiliated Hosp 14, Chengdu, Sichuan, Peoples R China.
Yang, J (reprint author), Univ New South Wales, George Inst Global Hlth, Fac Med, Sydney, NSW, Australia.
Anderson, CS (reprint author), Peking Univ, Hlth Sci Ctr, George Inst Global Hlth, Beijing, Peoples R China.
Keywords ACUTE ISCHEMIC-STROKE
HEALTH-CARE PROFESSIONALS
INTRAVENOUS ALTEPLASE
POOLED ANALYSIS
THROMBOLYSIS
ASSOCIATION
WEEKENDS
THERAPY
ONSET
Issue Date 2017
Publisher SCIENTIFIC REPORTS
Citation SCIENTIFIC REPORTS. 2017, 7.
Abstract Door-to-needle time (DNT) is a key performance indicator for efficient use of intravenous thrombolysis in acute ischemic stroke (AIS). We aimed to determine whether DNT improved over time in the Enhanced Control of Hypertension and Acute Stroke Study (ENCHANTED) and the clinical predictors of DNT. Temporal trends in DNT were assessed across fourths of time since activation of study centers using generalized linear model. Predictors of long DNT (> 60 min) were determined in logistic regression models. Overall mean DNT (min) was 71.8 (95% confidence interval [CI] 70.4-73.2), but decreased significantly over time (fourths): 77.9 (74.9-80.9), 69.3 (66.7-72.0), 69.1 (66.5-71.8) and 71.4 (68.774.2) (P for trend, 0.003). The reduction in DNT was particularly marked in China (P for trend, 0.001), but was not significant across the other participating countries (P for trend, 0.065). Independent predictors of long DNT were recruitment from China, short onset-to-door time, lower numbers of patients treated per center, higher diastolic blood pressure, off-hour admission, and absence of proximal clot occlusion. DNT in ENCHANTED declined progressively during the trial, especially in China. However, DNT in China is still longer than the key performance parameter of <= 60 minutes recommended in guidelines. Effective national programs are needed to improve DNT in China.
URI http://hdl.handle.net/20.500.11897/484589
ISSN 2045-2322
DOI 10.1038/s41598-017-14164-8
Indexed SCI(E)
Appears in Collections: 医学部待认领

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