Comparison of acute ischemic stroke patients receiving thrombolytic therapy: Patients admitted to the emergency department direct and after telestroke thrombolytic therapy and those referred to thrombolytic therapy

Abstract

Aim: To evaluate treatment times and outcomes in patients receiving intravenous thrombolytic therapy via different protocols. This analysis focused on three distinct patient groups: those directly admitted to a central emergency department with suspected acute ischemic stroke, those brought to the stroke center by emergency services from other centers for thrombolytic therapy, and those receiving telestroke consultation-supported thrombolytic therapy before transfer.

Method: This retrospective study reviewed medical records of 198 acute ischemic stroke patients admitted to a tertiary hospital emergency department between January 1, 2017, and December 31, 2020. Demographic data, admission and treatment times, clinical outcomes (modified Rankin and National Institutes of Health Stroke Scale (NIHSS)), and three-month mortality rates were assessed.

Results: Common risk factors were hypertension, atherosclerosis, diabetes, and hyperlipidemia. Stroke etiology included large artery atherosclerosis and small vessel occlusion in 26.3% of cases, and cardioembolic stroke in 17.2%. Patients with higher modified Rankin scores also had significantly higher NIHSS. A significant reduction in modified Rankin scores was observed at the third month across patient groups, though no significant differences were found in recanalization times or third-month scores between groups.

Conclusion: The “drip and send” method for rapid transfer to stroke centers was shown to be critical in improving clinical outcomes, emphasizing the importance of early intervention in stroke prognosis. This study supports adopting the “drip and send” model as a standard stroke treatment approach.