Shorter door-to-needle time lowers mortality, readmission in stroke: JAMA

USA: Shorter door-to-needle times in stroke patients (aged 65 years or older) treated with tissue plasminogen activator (tPA), lowers mortality, and hospital readmission at 1 year, according to a recent study. The findings, published in the journal JAMA, support evidence that shortening time to thrombolytic therapy is associated with improved outcomes.

Previous studies have shown earlier administration of intravenous tissue plasminogen activator in acute ischemic stroke to be associated with reduced mortality by the time of discharge from hospital. However, there is a lack of clarity on whether shorter door-to-needle times leads to a better long-term outcome. 

Shumei Man, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, and colleagues examined whether the shorter door to needle times with intravenous tPA for acute ischemic stroke is associated with improved long-term outcomes.

The study included Medicare beneficiaries aged 65 years or older (n=61,426) with acute ischemic stroke and were treated with IV tPA within 4.5 hours from the time they were last known to be well at Get With The Guidelines–Stroke participating hospitals between January 1, 2006, and December 31, 2016, with 1-year follow-up through December 31, 2017.