Stroke 20 20: Implementation goals for intravenous thrombolysis

J 2021

Stroke 20 20: Implementation goals for intravenous thrombolysis

MIKULÍK, Robert, Michal BAR, David CERNIK, Roman HERZIG, René JURA et. al.

Basic information

Original name

Stroke 20 20: Implementation goals for intravenous thrombolysis

Authors

MIKULÍK, Robert (203 Czech Republic, guarantor, belonging to the institution), Michal BAR (203 Czech Republic), David CERNIK (203 Czech Republic), Roman HERZIG (203 Czech Republic), René JURA (203 Czech Republic, belonging to the institution), Lubomir JURAK (203 Czech Republic), Jiri NEUMANN (203 Czech Republic), Daniel SANAK (203 Czech Republic), Svatopluk OSTRY (203 Czech Republic), Petr SEVCIK (203 Czech Republic), Ondrej SKODA (203 Czech Republic), David SKOLOUDIK (203 Czech Republic), Daniel VACLAVIK (203 Czech Republic) and Ales TOMEK (203 Czech Republic)

Edition

EUROPEAN STROKE JOURNAL, LONDON, SAGE PUBLICATIONS LTD, 2021, 2396-9873

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 5.894

RIV identification code

RIV/00216224:14110/21:00121597

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1177/23969873211007684

UT WoS

000641919100001

Keywords in English

Thrombolytic rate; stroke care management; implementation of thrombolysis; acute stroke care

Abstract

V originále

Introduction Knowledge of the implementation gap would facilitate the use of intravenous thrombolysis in stroke, which is still low in many countries. The study was conducted to identify national implementation targets for the utilisation and logistics of intravenous thrombolysis. Material and Method Multicomponent interventions by stakeholders in health care to optimise prehospital and hospital management with the goal of fast and accessible intravenous thrombolysis for every candidate. Implementation results were documented from prospectively collected cases in all 45 stroke centres nationally. The thrombolytic rate was calculated from the total number of all ischemic strokes in the population of the Czech Republic since 2004. Results Thrombolytic rates of 1.3 (95%CI 1.1 to 1.4), 5.4 (95%CI 5.1 to 5.7), 13.6 (95%CI 13.1 to 14.0), 23.3 (95%CI 22.8 to 23.9), and 23.5% (95%CI 23.0 to 24.1%) were achieved in 2005, 2009, 2014, 2017, and 2018, respectively. National median door-to-needle times were 60-70 minutes before 2012 and then decreased progressively every year to 25 minutes (IQR 17 to 36) in 2018. In 2018, 33% of both university and non-university hospitals achieved median door-to-needle time <= 20 minutes. In 2018, door-to-needle times <= 20, <= 45, and <= 60 minutes were achieved in 39, 85, and 93% of patients. Discussion Thrombolysis can be provided to >= 20% of all ischemic strokes nationwide and it is realistic to achieve median door-to-needle time 20 minutes. Conclusion Stroke 20-20 could serve as national implementation target for intravenous thrombolysis and country specific implementation policies should be applied to achieve such target.

Links

90128, large research infrastructures

Name: CZECRIN III

Citovat

MIKULÍK, Robert, Michal BAR, David CERNIK, Roman HERZIG, René JURA, Lubomir JURAK, Jiri NEUMANN, Daniel SANAK, Svatopluk OSTRY, Petr SEVCIK, Ondrej SKODA, David SKOLOUDIK, Daniel VACLAVIK and Ales TOMEK. Stroke 20 20: Implementation goals for intravenous thrombolysis. EUROPEAN STROKE JOURNAL. LONDON: SAGE PUBLICATIONS LTD, 2021, vol. 6, No 2, p. 151-159. ISSN 2396-9873. Available from: https://dx.doi.org/10.1177/23969873211007684.

@article{1769257,
   author = {Mikulík, Robert and Bar, Michal and Cernik, David and Herzig, Roman and Jura, René and Jurak, Lubomir and Neumann, Jiri and Sanak, Daniel and Ostry, Svatopluk and Sevcik, Petr and Skoda, Ondrej and Skoloudik, David and Vaclavik, Daniel and Tomek, Ales},
   article_location = {LONDON},
   article_number = {2},
   doi = {http://dx.doi.org/10.1177/23969873211007684},
   keywords = {Thrombolytic rate; stroke care management; implementation of thrombolysis; acute stroke care},
   language = {eng},
   issn = {2396-9873},
   journal = {EUROPEAN STROKE JOURNAL},
   title = {Stroke 20 20: Implementation goals for intravenous thrombolysis},
   url = {https://journals.sagepub.com/doi/pdf/10.1177/23969873211007684},
   volume = {6},
   year = {2021}
}

TY  - JOUR
ID  - 1769257
AU  - Mikulík, Robert - Bar, Michal - Cernik, David - Herzig, Roman - Jura, René - Jurak, Lubomir - Neumann, Jiri - Sanak, Daniel - Ostry, Svatopluk - Sevcik, Petr - Skoda, Ondrej - Skoloudik, David - Vaclavik, Daniel - Tomek, Ales
PY  - 2021
TI  - Stroke 20 20: Implementation goals for intravenous thrombolysis
JF  - EUROPEAN STROKE JOURNAL
VL  - 6
IS  - 2
SP  - 151-159
EP  - 151-159
PB  - SAGE PUBLICATIONS LTD
SN  - 23969873
KW  - Thrombolytic rate
KW  - stroke care management
KW  - implementation of thrombolysis
KW  - acute stroke care
UR  - https://journals.sagepub.com/doi/pdf/10.1177/23969873211007684
N2  - Introduction Knowledge of the implementation gap would facilitate the use of intravenous thrombolysis in stroke, which is still low in many countries. The study was conducted to identify national implementation targets for the utilisation and logistics of intravenous thrombolysis. Material and Method Multicomponent interventions by stakeholders in health care to optimise prehospital and hospital management with the goal of fast and accessible intravenous thrombolysis for every candidate. Implementation results were documented from prospectively collected cases in all 45 stroke centres nationally. The thrombolytic rate was calculated from the total number of all ischemic strokes in the population of the Czech Republic since 2004. Results Thrombolytic rates of 1.3 (95%CI 1.1 to 1.4), 5.4 (95%CI 5.1 to 5.7), 13.6 (95%CI 13.1 to 14.0), 23.3 (95%CI 22.8 to 23.9), and 23.5% (95%CI 23.0 to 24.1%) were achieved in 2005, 2009, 2014, 2017, and 2018, respectively. National median door-to-needle times were 60-70 minutes before 2012 and then decreased progressively every year to 25 minutes (IQR 17 to 36) in 2018. In 2018, 33% of both university and non-university hospitals achieved median door-to-needle time <= 20 minutes. In 2018, door-to-needle times <= 20, <= 45, and <= 60 minutes were achieved in 39, 85, and 93% of patients. Discussion Thrombolysis can be provided to >= 20% of all ischemic strokes nationwide and it is realistic to achieve median door-to-needle time 20 minutes. Conclusion Stroke 20-20 could serve as national implementation target for intravenous thrombolysis and country specific implementation policies should be applied to achieve such target.
ER  -

MIKULÍK, Robert, Michal BAR, David CERNIK, Roman HERZIG, René JURA, Lubomir JURAK, Jiri NEUMANN, Daniel SANAK, Svatopluk OSTRY, Petr SEVCIK, Ondrej SKODA, David SKOLOUDIK, Daniel VACLAVIK and Ales TOMEK. Stroke 20 20: Implementation goals for intravenous thrombolysis. \textit{EUROPEAN STROKE JOURNAL}. LONDON: SAGE PUBLICATIONS LTD, 2021, vol.~6, No~2, p.~151-159. ISSN~2396-9873. Available from: https://dx.doi.org/10.1177/23969873211007684.

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