ArticleScandinavian journal of trauma, resuscitation and emergency medicine2017
The golden hour of acute ischemic stroke.
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Home rehabilitation using android-based system as booster on the independences of stroke patients in local government hospital in Aceh, Indonesia.Acta bio-medica : Atenei Parmensis · 2023Trial
- Direct stroke unit access versus a hub-and-spoke model with telemedicine-assisted CT in Germany: a cross-sectional geospatial analysis.The Lancet regional health. Europe · 2026Article
- A similar effect of fibrinogen on efficacy and safety of tenecteplaseJournal of translational internal medicine · 2025Article
- The intersection of ophthalmology and neurology: Diagnosing acute strokes through visual symptoms.Indian journal of ophthalmology · 2025Observational
- The underlying mechanism of calcium toxicity-induced autophagic cell death and lysosomal degradation in early stage of cerebral ischemia.Anatomy & cell biology · 2024Review
- Prehospital identification of acute ischaemic stroke with large vessel occlusion: a retrospective study from western Norway.Emergency medicine journal : EMJ · 2024Article
- Machine Learning-Based Prediction of Stroke in Emergency Departments.Therapeutic advances in neurological disorders · 2024Article
- The Development of Non-Invasive Optical Brain Pulse Monitoring: A Review.Medical devices (Auckland, N.Z.) · 2024Review
- Associations between emergency call stroke triage and pre-hospital delay, primary hospital admission, and acute reperfusion treatment among early comers with acute ischemic stroke.Internal and emergency medicine · 2023Observational
- Metric based virtual simulation training for endovascular thrombectomy improves interventional neuroradiologists' simulator performance.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2023Article
- Building a Machine Learning-based Ambulance Dispatch Triage Model for Emergency Medical Services.Health data science · 2023Article
- Simulation-based team-training in acute stroke: Is it safe to speed up?Brain and behavior · 2022Article
- Article
- High Neutrophil-Lymphocyte Ratio and Low Lymphocyte-Monocyte Ratio Combination after Thrombolysis Is a Potential Predictor of Poor Functional Outcome of Acute Ischemic Stroke.Journal of personalized medicine · 2022Article
- Application time and persistence of transcranial direct current stimulation (tDCS) against neuronal death resulting from transient cerebral ischemia.Laboratory animal research · 2022Article
- Role of Telemedicine in Prehospital Stroke Care.Current cardiology reports · 2021Review
- Time-Based Decision Making for Reperfusion in Acute Ischemic Stroke.Frontiers in neurology · 2021Review
- Article
- Blood Pressure Variability during Angiography in Patients with Ischemic Stroke and Intracranial Artery Stenosis.International journal of hypertension · 2020Article
- Using artificial intelligence for improving stroke diagnosis in emergency departments: a practical framework.Therapeutic advances in neurological disorders · 2020Review
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute Ischemic Stroke (AIS) treatment has been revolutionised in the last two decades with the increasing use of Intravenous Thrombolysis (IVT) and with the advent of Endovascular therapy (EVT). AIS treatment and outcome are time dependant and time saving measures are being implemented at every step of the treatment chain. These changes have resulted in lower treatment times in-hospital, but it is unclear if this translates into more patients being treated within 60 min of symptom onset - the Golden Hour. The clinical outcome of IVT therapy in this patient group was our secondary outcome.
methodsFrom 2009 onwards, systematic changes were made to the AIS treatment chain leading to a dramatic decrease in Door-to-Needle (DTN) time. Analyses were performed on the number of these treatments year on year and their clinical outcomes within the Golden Hour at Stavanger University Hospital (SUS).
resultsSix-hundred and thirteen patients were included; seventy-three were treated within the Golden Hour. The percentage of total IVT treatments occurring in the Golden Hour rose from 2.2% in 2009 to 14.5% in 2015 (p = 0.006) with a high of 18.3% in 2012 (p < 0.001). All of these patients had a Median NIHSS of 0 at discharge, irrespective of age and pre-existing comorbidity. There was no incidence of any ICH and in-hospital mortality was only 2.7% in this group. DISCUSSION: The time from AIS symptom onset to treatment is filled with delays. Despite the inherence of some delays,significant efforts on the part of the pre- and in- hospital treatment chain have made IVT therapy within 60 min a possibility. The allocation and use of resources in the setting of rapid AIS treatment is warrantedand yields unprecedented results.
conclusionsOur study shows that improved treatment routines led to an increase in the number of patients treated within the Golden Hour. Treatment in the Golden Hour leads to excellent outcomes in all patients, irrespective of age and pre-existing comorbidity.
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