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    Helsinki Stroke Model Is Transferrable With "Real-World" Resources and Reduced Stroke Thrombolysis Delay to 34 min in Christchurch

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    Author
    Wu, TY; Coleman, E; Wright, SL; Mason, DF; Reimers, J; Duncan, R; Griffiths, M; Hurrell, M; Dixon, D; Weaver, J; ...
    Date
    2018-04-30
    Source Title
    Frontiers in Neurology
    Publisher
    FRONTIERS MEDIA SA
    University of Melbourne Author/s
    Meretoja, Atte
    Affiliation
    Medicine and Radiology
    Metadata
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    Document Type
    Journal Article
    Citations
    Wu, T. Y., Coleman, E., Wright, S. L., Mason, D. F., Reimers, J., Duncan, R., Griffiths, M., Hurrell, M., Dixon, D., Weaver, J., Meretoja, A. & Fink, J. N. (2018). Helsinki Stroke Model Is Transferrable With "Real-World" Resources and Reduced Stroke Thrombolysis Delay to 34 min in Christchurch. FRONTIERS IN NEUROLOGY, 9 (APR), https://doi.org/10.3389/fneur.2018.00290.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/255028
    DOI
    10.3389/fneur.2018.00290
    Abstract
    Background: Christchurch hospital is a tertiary hospital in New Zealand supported by five general neurologists with after-hours services provided mainly by onsite non-neurology medical residents. We assessed the transferrability and impact of the Helsinki Stroke model on stroke thrombolysis door-to-needle time (DNT) in Christchurch hospital. Methods: Key components of the Helsinki Stroke model were implemented first in 2015 with introduction of patient pre-notification and thrombolysis by the computed tomography (CT) suite, followed by implementation of direct transfer to CT on ambulance stretcher in May 2017. Data from the prospective thrombolysis registry which began in 2012 were analyzed for the impact of these interventions on median DNT. Results: Between May and December 2017, 46 patients were treated with alteplase, 25 (54%) patients were treated in-hours (08:00-17:00 non-public holiday weekdays) and 21 (46%) patients were treated after-hours. The in-hours, after-hours, and overall median (interquartile range) DNTs were 34 (28-43), 47 (38-60), and 40 (30-51) minutes. The corresponding times in 2012-2014 prior to interventions were 87 (68-106), 86 (72-116), and 87 (71-112) minutes, representing median DNT reduction of 53, 39, and 47 minutes, respectively (p-values <0.01). The interventions also resulted in significant reductions in the overall median door-to-CT time (from 49 to 19 min), CT-to-needle time (32 to 20 min) and onset-to-needle time (168 to 120 min). Conclusion: The Helsinki stroke model is transferrable with real-world resources and reduced stroke DNT in Christchurch by over 50%.

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