Higher all-cause readmission aHR 1.02 95% CI 1.01 to 1.03.Higher all-cause mortality aHR 1.04 95% CI 1.02 to 1.05 within 90 min, but not after 90 min aHR 1.01 95% CI 0.99 to 1.03.Every 15-minute increase in door-to-needle time was significantly associated with:.Median door-to-needle time = 65 min (Range 49 to 88 min).

61,426 patients treated with tPA within 4.5hrs.

Transferred to another acute care hospital, left AMA, or without a documented site of discharge disposition.

Missing door-to-needle time or treatment occurred >4.5hrs.

Missing onset-to-treatment time or treatment occurred >4.5hrs.Treated with concomitant therapy (i.e.1 st admission for stroke during the study period.Treated with tPA within 4.5hrs since last known well.Discharge diagnosis of acute ischemic stroke.Readmission for TIA, ischemic and hemorrhagic cc stroke, carotid endarterectomy or stenting, but not for direct complications of index stroke.1-year cardiovascular readmission (primary discharge diagnosis of HTN, CAD, MI, CHF, abdominal or aortic aneurysm, valvular disease, and cardiac arrhythmias).

1-year composite of all-cause mortality or readmission.Compared tPA administration at >45 min vs ≤45min and > 60 min vs ≤ 60 min.Patients collected from the Get With the Guidelines-Stroke Participating hospitals (See discussion for issues with this).Retrospective cohort study of Medicare beneficiaries ≥65 years of age treated for acute ischemic stroke with intravenous tPA within 4.5 hours from the time last known well with 1 year follow up.PMID: 32484532Ĭlinical Question: Is shorter door-to-needle times with tPA for acute ischemic stroke in patients ≥65 years associated with improved long-term outcomes? What They Did: Association Between Thrombolytic Door-to-Needle time and 1-Year Mortality and Readmission in Patients with Acute Ischemic Stroke. Click here for Direct Download of Podcast

Well here we are again