Verification of door-in door-out time (DIDO time) at a core hospital in rural medical area without primary stroke center

Abstract

Background and Purpose: This area is a rare primary stroke center (PSC) blank secondary medical area in Japan, and our hospital is the only designated emergency hospital in the area. In a primary care facility like our hospital, it is necessary to shorten the time from arrival at the hospital to the start of transfer (door-in door-out time [DIDO time]) as much as possible; however, there are very few reports on DIDO in Japan. We therefore conducted a retrospective survey to clarify the current situation in the area. Methods: Among the 25 cases of cerebral infarction with internal carotid artery (ICA) or M1 (horizontal segment of middle cerebral artery) obstruction encountered at our emergency outpatient department from April 2018 to March 2021, the data of 7 cases transferred to an emergency hospital were evaluated and verified. Results: The median DIDO time was 140 minutes (97–180 minutes). Conclusion: Information sharing and cooperation beyond the secondary medical area are required to improve access to thrombectomy therapy.