title: Point-of-care laboratory halves door-to-therapy-decision time in acute stroke.
abstract: Currently, stroke laboratory examinations are usually performed in the centralized hospital laboratory, but often planned thrombolysis is given before all results are available, to minimize delay. In this study, we examined the feasibility of gaining valuable time by transferring the complete stroke laboratory workup required by stroke guidelines to a point-of-care laboratory system, that is, placed at a stroke treatment room contiguous to the computed tomography, where the patients are admitted and where they obtain neurological, laboratory, and imaging examinations and treatment by the same dedicated team. Our results showed that reconfiguration of the entire stroke laboratory analysis to a point-of-care system was feasible for 200 consecutively admitted patients. This strategy reduced the door-to-therapy-decision times from 84 ± 26 to 40 ± 24 min (p < 0.001). Results of most laboratory tests (except activated partial thromboplastin time and international normalized ratio) revealed close agreement with results from a standard centralized hospital laboratory. These findings may offer a new solution for the integration of laboratory workup into routine hyperacute stroke management.
authors.affiliation: Department of Neurology, University of the Saarland, Homburg, Germany.
authors.forename: Silke
authors.initials: S
authors.lastname: Walter
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kostopoulos
authors.forename: Anton
authors.initials: A
authors.lastname: Haass
authors.forename: Martin
authors.initials: M
authors.lastname: Lesmeister
authors.forename: Mihaela
authors.initials: M
authors.lastname: Grasu
authors.forename: Iris
authors.initials: I
authors.lastname: Grunwald
authors.forename: Isabel
authors.initials: I
authors.lastname: Keller
authors.forename: Stephan
authors.initials: S
authors.lastname: Helwig
authors.forename: Carmen
authors.initials: C
authors.lastname: Becker
authors.forename: Juergen
authors.initials: J
authors.lastname: Geisel
authors.forename: Thomas
authors.initials: T
authors.lastname: Bertsch
authors.forename: Sarah
authors.initials: S
authors.lastname: Kaffiné
authors.forename: Annika
authors.initials: A
authors.lastname: Leingärtner
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Papanagiotou
authors.forename: Christian
authors.initials: C
authors.lastname: Roth
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Reith
authors.forename: Klaus
authors.initials: K
authors.lastname: Fassbender
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000628:therapy*; D003657:Decision Making; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D011446:Prospective Studies; D020521:Stroke / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors
chemical_list: D005343:Fibrinolytic Agents