A new study published in the Journal of the American Heart Association suggests that the delivery speed of a clot-busting drug to stroke patients is often overestimated by hospitals.
The tissue plasminogen activator (tPA) drug can reduce the effects of a stroke; however, it should be administered to ischemic stroke patients within one hour of their arrival times at the hospital (door-to-needle time).
To observe how quickly hospitals administer tPA to stroke patients upon hospital arrival, study researchers surveyed staff from 141 hospitals in the U.S., who treated 48,201 stroke patients between 2009 and 2010.
Data was also gathered from patients that detailed their stroke symptoms upon time of arrival, at what point they received tPA and whether or not they experienced other complications due to the drug.
Hospitals were ranked into three separate categories: high-, middle-, or low-performing. Ranking was based on the number of cases in which stroke patients received the drug within the recommended time.
Researchers discovered that only 29% of hospital staff identified their door-to-needle time correctly, and about 20% of low-performing hospitals believed that their door-to-needle time was above the national average. Approximately 85% of low-performing hospitals and 42% of middle-performing hospitals overestimated their ability to administer tPA to stroke patients immediately.
Furthermore, the volume of stroke patients arriving at each hospital influenced the disparity between hospital perception of tPA administration and actual performance.
Researchers conclude that institutions could benefit from protocol changes that could better align performance with reception.
Sources for Today’s Article:
Lin, C., et al., “Perception versus actual performance in timely tissue plasminogen activation administration in the management of acute ischemic stroke,” Journal of the American Heart Association 2015; 4:e001298, doi: 10.1161/JAHA.114.001298.
Whiteman, H., “Delivery speed of clot-busting drug for stroke often overestimated by hospitals,” Medical News Today web site, July 23, 2015; http://www.medicalnewstoday.com/articles/297093.php.