ArticleJournal of personalized medicine2024
Code Stroke Alert: Focus on Emergency Department Time Targets and Impact on Door-to-Needle Time across Day and Night Shifts.
Article in Journal of personalized medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Agreement and Classification Performance of a Mobile Self-Triage Application Based on the Manchester Triage System in Hemodynamically Stable Adult Walk-In Emergency Department Patients: A Prospective Observational Study.Journal of clinical medicine · 2026Article
- Cognitive Decline in Chronic Coronary Syndrome: Associations with Vascular, Cardiac, and Neuropsychological Parameters.Medicina (Kaunas, Lithuania) · 2026Observational
- Long COVID and Acute Stroke in the Emergency Department: An Analysis of Presentation, Reperfusion Treatment, and Early Outcomes.Journal of clinical medicine · 2025Article
- Performance of GFAP and UCH-L1 for Early Acute Stroke Diagnosis in the Emergency Department.Journal of clinical medicine · 2025Article
- Association Between Pre-Admission ATRIA Scores and Initial Stroke Severity in Acute Ischemic Stroke: A Cross-Sectional Study.Journal of clinical medicine · 2025Article
- Evolution of Hospitalisation Due to Stroke in Italy Before and After the Outbreak of the COVID-19 Epidemic: A Population-Based Study Using Administrative Data.Journal of clinical medicine · 2025Article
- Streamlining Acute Stroke Processes and Data Collection: A Narrative Review.Healthcare (Basel, Switzerland) · 2024Review
- Evaluating Thrombolysis Rates and Emergency Department Time Targets in Acute Ischemic Stroke: Need for Personalized Medicine.Journal of personalized medicine · 2024Article
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Authors and funding
13 authors.
Funding
Abstract
BACKGROUND AND
objectivesTo minimize stroke-related deaths and maximize the likelihood of cerebral reperfusion, medical professionals developed the "code stroke" emergency protocol, which allows for the prompt evaluation of patients with acute ischemic stroke symptoms in pre-hospital care and the emergency department (ED). This research will outline our experience in implementing the stroke code protocol for acute ischemic stroke patients and its impact on door-to-needle time (DTN) in the ED.
methodsOur study included patients with a "code stroke alert" upon arrival at the emergency department. The final sample of this study consisted of 258 patients eligible for intravenous (IV) thrombolysis with an onset-to-door time < 4.5 h. ED admissions were categorized into two distinct groups: "day shift" (from 8 a.m. to 8 p.m.) (n = 178) and "night shift" (from 8 p.m. to 8 a.m.) (n = 80) groups.
resultsAn analysis of ED time targets showed an increased median during the day shift for onset-to-ED door time of 310 min (IQR, 190-340 min), for door-to-physician (emergency medicine doctor) time of 5 min (IQR, 3-9 min), for door-to-physician (emergency medicine doctor) time of 5 min (IQR, 3-9 min), and for door-to-physician (neurologist) time of 7 min (IQR, 5-10 min), also during the day shift. During the night shift, an increased median was found for door-to-CT time of 21 min (IQR, 16.75-23 min), for door-to-CT results of 40 min (IQR, 38-43 min), and for door-to-needle time of 57.5 min (IQR, 46.25-60 min). Astonishingly, only 17.83% (n = 46) of these patients received intravenous thrombolysis, and the proportion of patients with thrombolysis was significantly higher during the night shift (
conclusionsThis study identified higher door-to-CT and door-to-emergency medicine physician times associated with an increased DTN, highlighting further opportunities to improve acute stroke care in the emergency department. Further, door-to-CT and door-to-CT results showed statistically significant increases during the night shift.
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