A national evaluation of door-to-imaging times among acute ischemic stroke patients within the veterans health administration

Kori Sauser, Dawn Bravata, Rodney A. Hayward, Deborah A. Levine

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background Rapid brain imaging for ischemic stroke is important for patient outcomes. We sought to determine the proportion of ischemic stroke patients receiving brain imaging within the guideline-recommended 24 hours, and predictors of faster imaging among patients with acute symptoms. Methods Retrospective analysis of Veterans Health Administration (VHA) Office of Performance Measurement Stroke Special Project data. Of 3000 ischemic stroke patients, secondary samples included 649 presenting within 6 hours of onset, and 217 potentially tissue plasminogen activator (tPA)-eligible patients (onset-to-arrival time <3 hours, National Institutes of Health Stroke Scale >2). Two linear regression models examined the association between door-to-imaging time and predictors among secondary samples, accounting for clustering within hospital. Results Of the 3000 ischemic stroke patients, 97.1% had brain imaging within 24 hours. Among patients presenting within 6 hours of onset, median door-to-imaging time was 59 minutes (interquartile range [IQR], 33-109). Predictors of faster door-to-imaging time included elevated arrival blood pressure and stroke center presentation. Among the potentially tPA-eligible patients, median door-to-imaging time was 52 minutes (IQR, 31-105); no significant predictors were identified. Conclusions Nearly all ischemic stroke patients at VHA hospitals have door-to-imaging time within 24 hours. There remains room for improvement for timely brain imaging among patients with acute symptom onset.

Original languageEnglish
Pages (from-to)1329-1332
Number of pages4
JournalJournal of Stroke and Cerebrovascular Diseases
Volume24
Issue number6
DOIs
StatePublished - Jun 1 2015

Fingerprint

Veterans Health
United States Department of Veterans Affairs
Stroke
Neuroimaging
Tissue Plasminogen Activator
Linear Models
Cluster Analysis
Guidelines
Blood Pressure

Keywords

  • brain imaging
  • emergency care
  • Stroke
  • veterans

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Rehabilitation
  • Cardiology and Cardiovascular Medicine

Cite this

A national evaluation of door-to-imaging times among acute ischemic stroke patients within the veterans health administration. / Sauser, Kori; Bravata, Dawn; Hayward, Rodney A.; Levine, Deborah A.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 24, No. 6, 01.06.2015, p. 1329-1332.

Research output: Contribution to journalArticle

@article{e3c946c739464b1a8055bc2731708ef3,
title = "A national evaluation of door-to-imaging times among acute ischemic stroke patients within the veterans health administration",
abstract = "Background Rapid brain imaging for ischemic stroke is important for patient outcomes. We sought to determine the proportion of ischemic stroke patients receiving brain imaging within the guideline-recommended 24 hours, and predictors of faster imaging among patients with acute symptoms. Methods Retrospective analysis of Veterans Health Administration (VHA) Office of Performance Measurement Stroke Special Project data. Of 3000 ischemic stroke patients, secondary samples included 649 presenting within 6 hours of onset, and 217 potentially tissue plasminogen activator (tPA)-eligible patients (onset-to-arrival time <3 hours, National Institutes of Health Stroke Scale >2). Two linear regression models examined the association between door-to-imaging time and predictors among secondary samples, accounting for clustering within hospital. Results Of the 3000 ischemic stroke patients, 97.1{\%} had brain imaging within 24 hours. Among patients presenting within 6 hours of onset, median door-to-imaging time was 59 minutes (interquartile range [IQR], 33-109). Predictors of faster door-to-imaging time included elevated arrival blood pressure and stroke center presentation. Among the potentially tPA-eligible patients, median door-to-imaging time was 52 minutes (IQR, 31-105); no significant predictors were identified. Conclusions Nearly all ischemic stroke patients at VHA hospitals have door-to-imaging time within 24 hours. There remains room for improvement for timely brain imaging among patients with acute symptom onset.",
keywords = "brain imaging, emergency care, Stroke, veterans",
author = "Kori Sauser and Dawn Bravata and Hayward, {Rodney A.} and Levine, {Deborah A.}",
year = "2015",
month = "6",
day = "1",
doi = "10.1016/j.jstrokecerebrovasdis.2015.02.007",
language = "English",
volume = "24",
pages = "1329--1332",
journal = "Journal of Stroke and Cerebrovascular Diseases",
issn = "1052-3057",
publisher = "W.B. Saunders Ltd",
number = "6",

}

TY - JOUR

T1 - A national evaluation of door-to-imaging times among acute ischemic stroke patients within the veterans health administration

AU - Sauser, Kori

AU - Bravata, Dawn

AU - Hayward, Rodney A.

AU - Levine, Deborah A.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Background Rapid brain imaging for ischemic stroke is important for patient outcomes. We sought to determine the proportion of ischemic stroke patients receiving brain imaging within the guideline-recommended 24 hours, and predictors of faster imaging among patients with acute symptoms. Methods Retrospective analysis of Veterans Health Administration (VHA) Office of Performance Measurement Stroke Special Project data. Of 3000 ischemic stroke patients, secondary samples included 649 presenting within 6 hours of onset, and 217 potentially tissue plasminogen activator (tPA)-eligible patients (onset-to-arrival time <3 hours, National Institutes of Health Stroke Scale >2). Two linear regression models examined the association between door-to-imaging time and predictors among secondary samples, accounting for clustering within hospital. Results Of the 3000 ischemic stroke patients, 97.1% had brain imaging within 24 hours. Among patients presenting within 6 hours of onset, median door-to-imaging time was 59 minutes (interquartile range [IQR], 33-109). Predictors of faster door-to-imaging time included elevated arrival blood pressure and stroke center presentation. Among the potentially tPA-eligible patients, median door-to-imaging time was 52 minutes (IQR, 31-105); no significant predictors were identified. Conclusions Nearly all ischemic stroke patients at VHA hospitals have door-to-imaging time within 24 hours. There remains room for improvement for timely brain imaging among patients with acute symptom onset.

AB - Background Rapid brain imaging for ischemic stroke is important for patient outcomes. We sought to determine the proportion of ischemic stroke patients receiving brain imaging within the guideline-recommended 24 hours, and predictors of faster imaging among patients with acute symptoms. Methods Retrospective analysis of Veterans Health Administration (VHA) Office of Performance Measurement Stroke Special Project data. Of 3000 ischemic stroke patients, secondary samples included 649 presenting within 6 hours of onset, and 217 potentially tissue plasminogen activator (tPA)-eligible patients (onset-to-arrival time <3 hours, National Institutes of Health Stroke Scale >2). Two linear regression models examined the association between door-to-imaging time and predictors among secondary samples, accounting for clustering within hospital. Results Of the 3000 ischemic stroke patients, 97.1% had brain imaging within 24 hours. Among patients presenting within 6 hours of onset, median door-to-imaging time was 59 minutes (interquartile range [IQR], 33-109). Predictors of faster door-to-imaging time included elevated arrival blood pressure and stroke center presentation. Among the potentially tPA-eligible patients, median door-to-imaging time was 52 minutes (IQR, 31-105); no significant predictors were identified. Conclusions Nearly all ischemic stroke patients at VHA hospitals have door-to-imaging time within 24 hours. There remains room for improvement for timely brain imaging among patients with acute symptom onset.

KW - brain imaging

KW - emergency care

KW - Stroke

KW - veterans

UR - http://www.scopus.com/inward/record.url?scp=84930182243&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930182243&partnerID=8YFLogxK

U2 - 10.1016/j.jstrokecerebrovasdis.2015.02.007

DO - 10.1016/j.jstrokecerebrovasdis.2015.02.007

M3 - Article

C2 - 25881775

AN - SCOPUS:84930182243

VL - 24

SP - 1329

EP - 1332

JO - Journal of Stroke and Cerebrovascular Diseases

JF - Journal of Stroke and Cerebrovascular Diseases

SN - 1052-3057

IS - 6

ER -