Positive impact of the participation in the ENCHANTED trial in reducing Door-to-Needle Time

Abstract Door-to-needle time (DNT) is a key performance indicator for efficient use of intravenous thrombolysis in acute ischemic stroke (AIS). We aimed to determine whether DNT improved over time in the Enhanced Control of Hypertension and Acute Stroke Study (ENCHANTED) and the clinical predictors...

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Autores principales:	Jie Yang, Xia Wang, Jian ping Yu, Jing Hang, Pablo Lavados, Thompson Robinson, Hisatomi Arima, Richard I. Lindley, Craig S. Anderson, John Chalmers
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0143ddde0ff149758c627a2cecfced8b
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spelling	oai:doaj.org-article:0143ddde0ff149758c627a2cecfced8b2021-12-02T15:05:29ZPositive impact of the participation in the ENCHANTED trial in reducing Door-to-Needle Time10.1038/s41598-017-14164-82045-2322https://doaj.org/article/0143ddde0ff149758c627a2cecfced8b2017-10-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-14164-8https://doaj.org/toc/2045-2322Abstract Door-to-needle time (DNT) is a key performance indicator for efficient use of intravenous thrombolysis in acute ischemic stroke (AIS). We aimed to determine whether DNT improved over time in the Enhanced Control of Hypertension and Acute Stroke Study (ENCHANTED) and the clinical predictors of DNT. Temporal trends in DNT were assessed across fourths of time since activation of study centers using generalized linear model. Predictors of long DNT (>60 min) were determined in logistic regression models. Overall mean DNT (min) was 71.8 (95% confidence interval [CI] 70.4–73.2), but decreased significantly over time (fourths): 77.9 (74.9–80.9), 69.3 (66.7–72.0), 69.1 (66.5–71.8) and 71.4 (68.7–74.2) (P for trend, 0.003). The reduction in DNT was particularly marked in China (P for trend, 0.001), but was not significant across the other participating countries (P for trend, 0.065). Independent predictors of long DNT were recruitment from China, short onset-to-door time, lower numbers of patients treated per center, higher diastolic blood pressure, off-hour admission, and absence of proximal clot occlusion. DNT in ENCHANTED declined progressively during the trial, especially in China. However, DNT in China is still longer than the key performance parameter of ≤60 minutes recommended in guidelines. Effective national programs are needed to improve DNT in China.Jie YangXia WangJian ping YuJing HangPablo LavadosThompson RobinsonHisatomi ArimaRichard I. LindleyCraig S. AndersonJohn ChalmersNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-6 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jie Yang Xia Wang Jian ping Yu Jing Hang Pablo Lavados Thompson Robinson Hisatomi Arima Richard I. Lindley Craig S. Anderson John Chalmers Positive impact of the participation in the ENCHANTED trial in reducing Door-to-Needle Time
description	Abstract Door-to-needle time (DNT) is a key performance indicator for efficient use of intravenous thrombolysis in acute ischemic stroke (AIS). We aimed to determine whether DNT improved over time in the Enhanced Control of Hypertension and Acute Stroke Study (ENCHANTED) and the clinical predictors of DNT. Temporal trends in DNT were assessed across fourths of time since activation of study centers using generalized linear model. Predictors of long DNT (>60 min) were determined in logistic regression models. Overall mean DNT (min) was 71.8 (95% confidence interval [CI] 70.4–73.2), but decreased significantly over time (fourths): 77.9 (74.9–80.9), 69.3 (66.7–72.0), 69.1 (66.5–71.8) and 71.4 (68.7–74.2) (P for trend, 0.003). The reduction in DNT was particularly marked in China (P for trend, 0.001), but was not significant across the other participating countries (P for trend, 0.065). Independent predictors of long DNT were recruitment from China, short onset-to-door time, lower numbers of patients treated per center, higher diastolic blood pressure, off-hour admission, and absence of proximal clot occlusion. DNT in ENCHANTED declined progressively during the trial, especially in China. However, DNT in China is still longer than the key performance parameter of ≤60 minutes recommended in guidelines. Effective national programs are needed to improve DNT in China.
format	article
author	Jie Yang Xia Wang Jian ping Yu Jing Hang Pablo Lavados Thompson Robinson Hisatomi Arima Richard I. Lindley Craig S. Anderson John Chalmers
author_facet	Jie Yang Xia Wang Jian ping Yu Jing Hang Pablo Lavados Thompson Robinson Hisatomi Arima Richard I. Lindley Craig S. Anderson John Chalmers
author_sort	Jie Yang
title	Positive impact of the participation in the ENCHANTED trial in reducing Door-to-Needle Time
title_short	Positive impact of the participation in the ENCHANTED trial in reducing Door-to-Needle Time
title_full	Positive impact of the participation in the ENCHANTED trial in reducing Door-to-Needle Time
title_fullStr	Positive impact of the participation in the ENCHANTED trial in reducing Door-to-Needle Time
title_full_unstemmed	Positive impact of the participation in the ENCHANTED trial in reducing Door-to-Needle Time
title_sort	positive impact of the participation in the enchanted trial in reducing door-to-needle time
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/0143ddde0ff149758c627a2cecfced8b
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Positive impact of the participation in the ENCHANTED trial in reducing Door-to-Needle Time

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