2019 Volume 4 Issue 1 Pages 44-51
Objective: The purpose of this study was to investigate the effectiveness of standardized stroke diagnosistreatment system named “Stroke Scramble” on stroke care system and its clinical outcome.
Methods: From September 2012 to December 2017, acute ischemic stroke patients admitted to our institution within 4.5 h after symptom onset were enrolled. The number of thrombectomy, therapeutic time, and outcomes were retrospectively compared between before and after the introduction of the “Stroke scramble”.
Results: In acute ischemic stroke cases within 4.5 h after onset, the proportion of thrombectomy was significantly increased in the “Stroke Scramble” period (20/63, 32% vs. 86/117, 74%). Both door-to-puncture time (min, median 192, interquartile range [IQR] 146–218 vs. 85, IQR 65–103) and puncture-to-reperfusion time (min, 158, IQR 101–180 vs. 45, IQR 28–73) decreased, resulted in reducing onset-to-reperfusion time (min, 437, IQR 378–552 vs. 241, IQR 185–305). The proportion of successful recanalization (≥thrombolysis in cerebral infarction 2b) increased from 45 to 85% (P < 0.001) and the proportion of good outcome (modified Rankin Scale 0–2) at 90 days also increased from 15 to 42% (P = 0.038).
Conclusion: Standardization of acute stroke workflow by “Stroke Scramble” was associated with increased cases of thrombectomy, shortened therapeutic time, and improved clinical outcomes.
