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STROKE: Kaiser Permanente studies door-to-needle time

According to the American Stroke Association website, ischemic stroke – in which a clot blocks a blood vessel – is by far the most common type of stroke, occurring in just under 90 percent of cases.  If the stroke patient reaches care quickly enough, a good standard treatment is the administration of tissue plasminogen activator (tPA), but the key to improved outcomes is getting the drug administered quickly.

This was a study of 11,630 patients age 18 and over with ischemic stroke who arrived in the 14 emergency departments in the Kaiser Permanente Southern California health system from 2009 to 2013.  Interestingly, a relatively small percentage of these patients were treated with tPA – under 3 percent in 2009 and a little over 6 percent in 2013.  (The authors suggest that the reason that there was a low percentage of tPA administration was because patients were ineligible because they had not made it to the hospital in time for this therapy to be effective, or for other clinical reasons.)

During the 5 years of the study, Kaiser clinicians were able to shave time off of their door-to-imaging time – 46 minutes in the most recent year.  Likewise, they were able to decrease their door-to-needle time to 67 minutes in the most recent year.


American Stroke Association. (2016).  Click here: www.strokeassociation.org

Sauser-Zachrison, K., and others. (2016, Spring). Emergency care of patients with acute ischemic stroke in the Kaiser Permanente Southern California integrated health system. Permanente Journal, 20(2), 10-13. Click here: http://www.thepermanentejournal.org/files/Spring2016/KaiserPermanenteSouthernCalifornia.pdf Posed by AHA Resource Center (312) 422.2050, rc@aha.org

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