Assessment of management intervention model to increase the opportunity of indications for treatment with thrombolytic drugs among people with ischemic stroke in Pho Noi General Hospital, Hung Yen Province

Abstract

To improve the rate of patients with ischemic stroke who have treated with Alteplase and effective treatment, Pho Noi General Hospital has applied a multimodal intervention model in the pre-hospital and in-hospital stages, and after discharge. This study aims to evaluate the results of the model at Pho Noi General Hospital from January 2021 to June 2022 particularly the rate of early admits and the clinical outcome, and comparing with the period 2018 – 2020, which has not applied the intervention model. The study showed that 29.5% and 34.4% of patients came early at the 4.5 hour and 6 hours window after symptom onset, respectively, which were statistically significantly higher when they had compared with the period 2018- 2020. The door-needle time in the post-intervention period was 58.0 ± 21.5 minutes, which was statistically significantly lower than in the pre-intervention period, which was 64.6 ± 12.6 minutes. Patients being in the post-intervention stage had the rate of mRS 0-2 at discharge of 53.6%, which was statistically significantly higher than in the pre-intervention period of 44.6%. Conclusion: Our study shows that, after 1.5 years of applying the multimodal intervention model in the management of stroke patients in Pho Noi General hospital, the proportion of patients arriving early within the 4.5-hour and 6 hours window increased; decreased needle-todoor time and increased mRS 0-2 rate at discharge.