title: Intravenous thrombolysis for ischaemic stroke: short delays and high community-based treatment rates after organisational changes in a previously inexperienced centre.
abstract: OBJECTIVE
  To evaluate hospital delays in thrombolytic treatment before and after organisational changes and community-based treatment rates in a previously inexperienced centre.
  
  
  METHODS
  The delays before and after organisational changes made in 2006 were compared using a prospective treatment database. In a 6-month period in 2007, a community-based search was performed for all hospitalisations for ischaemic stroke. The number of patients admitted within the 0-3 h time window and the proportion treated with tissue plasminogen activator were analysed.
  
  
  RESULTS
  The number of treatments increased fourfold from 2005 to 2007 with a significant reduction in mean door-to-needle time from 60 min to 38 min (p = 0.002). In the community-based series, 14/137 patients (10%) hospitalised with ischaemic stroke and 13/32 patients (41%) admitted in the 0-3 h window were treated.
  
  
  CONCLUSIONS
  An inexperienced stroke centre can rapidly implement the necessary logistics to deliver thrombolysis to a large proportion of patients with acute stroke with short hospital delays. Important factors are probably prenotification of a team and the initiation of thrombolytic treatment in the emergency room.
authors.affiliation: Department of Neurology, Sørlandet Sykehus Kristiansand, 4604 Kristiansand, Norway. arnstein.tveiten@sshf.no
authors.forename: A
authors.initials: A
authors.lastname: Tveiten
authors.forename: A
authors.initials: A
authors.lastname: Mygland
authors.forename: U
authors.initials: U
authors.lastname: Ljøstad
authors.forename: L
authors.initials: L
authors.lastname: Thomassen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000188:drug therapy*; D003695:Delivery of Health Care / Q000458:organization & administration; D004363:Drug Utilization / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D011446:Prospective Studies; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D010959:Tissue Plasminogen Activator