Preliminary Study on the Optimization Effect of Intravenous Thrombolysis in Acute Ischemic Stroke in Lhasa

To explore the improvement effect of green channel process optimization in acute ischemic stroke (AIS) on intravenous thrombolysis (IVT) quality in Lhasa.

All patients with AIS who received IVT by the stroke center of Tibet Autonomous Region from August 2019 to December 2021 were included. According to whether the stroke green channel process was optimized, they were divided into the pre-optimization group (August 2019 to June 2021) and the post-optimization group (July to December 2021). The quality of IVT and stroke prognosis were compared and analyzed between the two groups.

A total of 34 patients with AIS who received IVT were included (an average of 1.2 patients per month), including 16 in the pre-optimization group and 18 in the post-optimization group. The National Institutes of Health Stroke Scale scores at baseline, immediately after thrombolysis, and 24 hours after thrombolysis were 6.5(3.0, 12.0), 3.0(1.0, 5.5)and 2.0(0, 6.3), respectively. The door to needle time in the post-optimization group was significantly shortened, as compared with that of the pre-optimization group[(67.1±37.8)min vs. (108.9±53.8)min, P=0.035]. Onset to needle time [(176.7±69.7)min vs. (199.1±47.8)min, P=0.065], the compliance rate of door to needle time ≤60 min (50.0% vs. 18.8%, P=0.061) and the proportion of good short-term efficacy of thrombolysis (77.8% vs. 62.5%, P=0.336) were improved, but the differences were not statistically significant.

After the process optimization of stroke green channel, the in-hospital delay of IVT for AIS in Lhasa is significantly improved, which is helpful to enhance the first-aid efficiency of early treatment of AIS.