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Fast Protocol for Treating Acute Ischemic Stroke by Emergency Physicians  Iiro Heikkilä, MD, Hanna Kuusisto, MD, PhD, Markus Holmberg, MD, Ari Palomäki,

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Presentation on theme: "Fast Protocol for Treating Acute Ischemic Stroke by Emergency Physicians  Iiro Heikkilä, MD, Hanna Kuusisto, MD, PhD, Markus Holmberg, MD, Ari Palomäki,"— Presentation transcript:

1 Fast Protocol for Treating Acute Ischemic Stroke by Emergency Physicians 
Iiro Heikkilä, MD, Hanna Kuusisto, MD, PhD, Markus Holmberg, MD, Ari Palomäki, MD, PhD  Annals of Emergency Medicine  Volume 73, Issue 2, Pages (February 2019) DOI: /j.annemergmed Copyright © 2018 American College of Emergency Physicians Terms and Conditions

2 Figure 1 The trial profile was a before-after intervention analysis. Group 1 (ie, “before”) represents 2009 to 2012; and group 2, 1 year (from October 1, 2013, until September 30, 2014). Annals of Emergency Medicine  , DOI: ( /j.annemergmed ) Copyright © 2018 American College of Emergency Physicians Terms and Conditions

3 Figure 2 A, Before the reorganization (group 1, 2009 to 2012), in median DNTs there were no trends either to decrease or increase (NS). B, In group 1 (ie, “before,” 2009 to 2012), median DNT was 54 minutes. After reorganization, it was 20 minutes (group 2 [ie, “after,” 12 months from October 1, 2013]). The difference (statistical estimate 32 minutes; 95% CI 26 to 38 minutes) was significant. DNT as in A. Also shown is a back-to-back histogram representing same results. Box plots represent medians and interquartile range. Whiskers and outliers (open circles) represent the whole range of DNTs. In group 1, minimum and maximum DNTs were 20 minutes and 2 hours, 11 minutes, respectively. In group 2, they were 8 and 60 minutes, respectively. Annals of Emergency Medicine  , DOI: ( /j.annemergmed ) Copyright © 2018 American College of Emergency Physicians Terms and Conditions

4 Figure 3 Median OTT was 135 minutes before reorganization (group 1). After implementation of the new stroke protocol, it was 119 minutes (group 2). The difference (statistical estimate 23 minutes; 95% CI 6 to 39 minutes) was significant (P=.006). Annals of Emergency Medicine  , DOI: ( /j.annemergmed ) Copyright © 2018 American College of Emergency Physicians Terms and Conditions

5 Figure 4 Main prerequisites and elements of the intervention. Modified from our earlier publication.7 INR, International normalized ratio. Annals of Emergency Medicine  , DOI: ( /j.annemergmed ) Copyright © 2018 American College of Emergency Physicians Terms and Conditions

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