Effectiveness of emergency physician determinations of the need for thrombolytic therapy in acute stroke.

Effectiveness of emergency physician determinations of the need for thrombolytic therapy in acute stroke. Proc (Bayl Univ Med Cent). 2019 Oct;32(4):485-489 Authors: Juergens AL, Barney J, Julakanti M, Allen L, Shaver C Abstract An increased emphasis on stroke care has led to a proliferation of specialized stroke teams despite relatively few trials demonstrating their efficacy. Our academic stroke center incorporated a unique setup allowing for the comparison between stroke teams and emergency physicians. During weekday working hours, a stroke team would respond to the emergency department for stroke activations. During all other times, the emergency physician caring for the patient would make all treatment decisions. We sought to determine whether there was any difference in treatment and outcomes between these two groups. We conducted a retrospective review of all stroke activations from January 2015 to June 2016 and compared the thrombolytic administration rates, modified Rankin Scale (mRS) at discharge, and change in National Institutes of Health Stroke Scale (NIHSS). A total of 415 stroke activations were identified. Of those, 69 of 262 patients (26.3%) seen by emergency physicians and 60 of 153 patients (39.2%) seen by neurologists received thrombolysis (P = 0.006). No significant difference was found in the discharge mRS or change in NIHSS between the two groups. Emergency physicians administered significantly less thrombol...
Source: Baylor University Medical Center Proceedings - Category: Universities & Medical Training Authors: Tags: Proc (Bayl Univ Med Cent) Source Type: research