Multidisciplinary protocol for rapid head computed tomography turnaround time in acute stroke patients

J Stroke Cerebrovasc Dis. 2015 Jun;24(6):1256-61. doi: 10.1016/j.jstrokecerebrovasdis.2015.01.029. Epub 2015 Apr 25.

Abstract

Background: The door-to-computed tomography (CT) head reporting time is an essential step to determining eligibility for thrombolysis in acute stroke patients, but the specific components of the process have not been reported in detail.

Methods: We performed a retrospective cross-sectional analysis of the prospectively collected Get-With-The-Guidelines database in our comprehensive stroke center to evaluate the effect of a structured multidisciplinary protocol on head CT times in acute stroke patients under consideration for thrombolysis.

Results: The median CT turnaround time in the first 6-month period was 27 (interquartile range [IQR], 27) and decreased in all subsequent periods after implementation of a formal protocol to 18 (IQR, 12; range, 17-20 minutes; P < .0001 for all pairwise comparisons). The median CT turnaround time was 18 (IQR, 12) versus 20 (IQR, 14) minutes for patients with admission diagnosis of stroke (n = 1123) versus nonstroke (n = 685; P < .0001), respectively.

Conclusions: A structured multidisciplinary protocol for obtaining acute stroke protocol head CT scan was associated with reduced CT turnaround time over the study period. Prospective studies should be done to determine if implementation in other stroke centers confirms the effectiveness of our protocol.

Keywords: Acute stroke; computed tomography; thrombolysis; turnaround time.

MeSH terms

  • Brain Ischemia / diagnostic imaging*
  • Brain Ischemia / drug therapy
  • Cerebral Angiography / methods
  • Clinical Protocols
  • Cross-Sectional Studies
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Retrospective Studies
  • Stroke / diagnostic imaging*
  • Stroke / drug therapy
  • Thrombolytic Therapy / methods
  • Time Factors
  • Time-to-Treatment
  • Tissue Plasminogen Activator / therapeutic use

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator