In patients with acute ischemic stroke, even small reductions in the time to thrombolytic therapy are associated with improved outcomes, according to a study in JAMA.
Using a national stroke registry, U.S. researchers examined outcomes among some 58,000 patients, at nearly 1400 hospitals, who received intravenous tissue plasminogen activator (tPA) within 4.5 hours after symptom onset. They found that with each 15-minute decrease in time to tPA therapy, patients were significantly less likely to die in the hospital or experience intracranial hemorrhage (odds ratio for each, 0.96). In addition, each 15-minute reduction was significantly associated with a greater likelihood to walk independently at discharge (OR, 1.04) and to be discharged home (OR, 1.03).
"These findings support intensive efforts to accelerate hospital presentation and thrombolytic treatment in patients with stroke," the researchers conclude.