Impact of demographic and clinical factors on in-hospital delays in acute ischemic stroke treatment.

Acute ischemic stroke in-hospital delay reperfusion women and minorities

Journal

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences
ISSN: 2385-2011
Titre abrégé: Interv Neuroradiol
Pays: United States
ID NLM: 9602695

Informations de publication

Date de publication:
25 Jul 2024
Historique:
medline: 26 7 2024
pubmed: 26 7 2024
entrez: 25 7 2024
Statut: aheadofprint

Résumé

Delays in reperfusion treatment, both intravenous thrombolysis (IVT) and endovascular treatment (EVT), adversely affect outcomes in patients with acute ischemic stroke (AIS). To alleviate these delays, it is essential to comprehend how patients' baseline and stroke characteristics impact in-hospital reperfusion delays. While demographic and socioeconomic factors affect stroke outcomes, their impact on in-hospital delays remains unclear. This is retrospective analysis at a tertiary stroke center, encompassing AIS patients receiving IVT and / or EVT between 2019 and 2022 (re-canalization cohort). Outcomes of interest were time intervals of admission to CT and admission to recanalization. Univariable analyses explored age, gender, baseline functional status, socioeconomic status (SES), ethnicity, vascular risk factors, and stroke characteristics. Subsequently, multivariable logistic regression analyses were performed. Altogether, 313 patients treated with IVT and 293 with EVT were included in the re-canalization cohort. No demographic variables were found to be associated with stroke treatment time intervals. Following multivariable analysis, stroke severity (low NIHSS, Our findings indicate that patients with a more severe ischemic stroke, typical stroke symptoms, and arrival by ambulance have shorter stroke treatment time intervals. These results emphasize that, in atypical cases, even a lower suspicion of stroke should promote urgent workup for stroke diagnosis. Our findings do not indicate any influence of demographic or SES on in-hospital reperfusion delays.

Sections du résumé

BACKGROUND BACKGROUND
Delays in reperfusion treatment, both intravenous thrombolysis (IVT) and endovascular treatment (EVT), adversely affect outcomes in patients with acute ischemic stroke (AIS). To alleviate these delays, it is essential to comprehend how patients' baseline and stroke characteristics impact in-hospital reperfusion delays. While demographic and socioeconomic factors affect stroke outcomes, their impact on in-hospital delays remains unclear.
METHOD METHODS
This is retrospective analysis at a tertiary stroke center, encompassing AIS patients receiving IVT and / or EVT between 2019 and 2022 (re-canalization cohort). Outcomes of interest were time intervals of admission to CT and admission to recanalization. Univariable analyses explored age, gender, baseline functional status, socioeconomic status (SES), ethnicity, vascular risk factors, and stroke characteristics. Subsequently, multivariable logistic regression analyses were performed.
RESULTS RESULTS
Altogether, 313 patients treated with IVT and 293 with EVT were included in the re-canalization cohort. No demographic variables were found to be associated with stroke treatment time intervals. Following multivariable analysis, stroke severity (low NIHSS,
CONCLUSION CONCLUSIONS
Our findings indicate that patients with a more severe ischemic stroke, typical stroke symptoms, and arrival by ambulance have shorter stroke treatment time intervals. These results emphasize that, in atypical cases, even a lower suspicion of stroke should promote urgent workup for stroke diagnosis. Our findings do not indicate any influence of demographic or SES on in-hospital reperfusion delays.

Identifiants

pubmed: 39053431
doi: 10.1177/15910199241264326
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

15910199241264326

Déclaration de conflit d'intérêts

Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Auteurs

Jonathan Naftali (J)

Department of Neurology, Rabin Medical Center, Petach Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.

Gal Tsur (G)

Department of Neurology, Rabin Medical Center, Petach Tikva, Israel.

Eitan Auriel (E)

Department of Neurology, Rabin Medical Center, Petach Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.

Guy Raphaeli (G)

Department of Neurology, Rabin Medical Center, Petach Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
Interventional Neuroradiology unit, Rabin Medical Center, Petach Tikva, Israel.

Michael Findler (M)

Department of Neurology, Rabin Medical Center, Petach Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
Interventional Neuroradiology unit, Rabin Medical Center, Petach Tikva, Israel.

Ran Brauner (R)

Department of Neurology, Rabin Medical Center, Petach Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
Interventional Neuroradiology unit, Rabin Medical Center, Petach Tikva, Israel.

Alain Perlow (A)

Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
Interventional Neuroradiology unit, Rabin Medical Center, Petach Tikva, Israel.

Ophir Keret (O)

Department of Neurology, Rabin Medical Center, Petach Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
Cognitive Neurology Clinic, Rabin Medical Center, Petach Tikva, Israel.

Rani Barnea (R)

Department of Neurology, Rabin Medical Center, Petach Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.

Classifications MeSH