BRUNSER RABOVICH, ALEJANDRO MICHELALEJANDRO MICHELBRUNSER RABOVICHJuan-Cristobal NuñezEloy MansillaGabriel CavadaOLAVARRIA IANISZEWSKY, VERONICA VIVIANAVERONICA VIVIANAOLAVARRIA IANISZEWSKYMUÑOZ VENTURELLI, PAULA ANDREAPAULA ANDREAMUÑOZ VENTURELLILAVADOS GERMAIN, PABLO MANUELPABLO MANUELLAVADOS GERMAIN2024-02-072024-02-072023Brunser, A. M., Nuñez, J.-C., Mansilla, E., Cavada, G., Olavarría, V., Muñoz Venturelli, P., & Lavados, P. M. (2023). Who is in the emergency room matters when we talk about door-to-needle time: A single-center experience. Arquivos de Neuro-Psiquiatria, 81(07), 624-631. https://doi.org/10.1055/s-0043-1768672https://hdl.handle.net/11447/8698https://investigadores.udd.cl/handle/123456789/846310.1055/s-0043-17686722-s2.0-85166362887WOS:001023387900004<jats:title>Abstract</jats:title><jats:p> Background The efficacy of intravenous thrombolysis (IVT) is time-dependent.</jats:p><jats:p> Objective To compare the door-to-needle (DTN) time of stroke neurologists (SNs) versus non-stroke neurologists (NSNs) and emergency room physicians (EPs). Additionally, we aimed to determine elements associated with DTN ≤ 20 minutes.</jats:p><jats:p> Methods Prospective study of patients with IVT treated at Clínica Alemana between June 2016 and September 2021.</jats:p><jats:p> Results A total of 301 patients underwent treatment for IVT. The mean DTN time was 43.3 ± 23.6 minutes. One hundred seventy-three (57.4%) patients were evaluated by SNs, 122 (40.5%) by NSNs, and 6 (2.1%) by EPs. The mean DTN times were 40.8 ± 23, 46 ± 24.7, and 58 ± 22.5 minutes, respectively. Door-to-needle time ≤ 20 minutes occurred more frequently when patients were treated by SNs compared to NSNs and EPs: 15%, 4%, and 0%, respectively (odds ratio [OR]: 4.3, 95% confidence interval [95%CI]: 1.66–11.5, p = 0.004). In univariate analysis DTN time ≤ 20 minutes was associated with treatment by a SN (p = 0.002), coronavirus disease 2019 pandemic period (p = 0.21), time to emergency room (ER) (p = 0.21), presence of diabetes (p = 0.142), hypercholesterolemia (p = 0.007), atrial fibrillation (p &lt; 0.09), score on the National Institutes of Health Stroke Scale (NIHSS) (p = 0.001), lower systolic (p = 0.143) and diastolic (p = 0.21) blood pressures, the Alberta Stroke Program Early CT Score (ASPECTS; p = 0.09), vessel occlusion (p = 0.05), use of tenecteplase (p = 0.18), thrombectomy (p = 0.13), and years of experience of the physician (p &lt; 0.001). After multivariate analysis, being treated by a SN (OR: 3.95; 95%CI: 1.44–10.8; p = 0.007), NIHSS (OR: 1.07; 95%CI: 1.02–1.12; p &lt; 0.002) and lower systolic blood pressure (OR: 0.98; 95%CI: 0.96–0.99; p &lt; 0.003) remained significant.</jats:p><jats:p> Conclusion Treatment by a SN resulted in a higher probability of treating the patient in a DTN time within 20 minutes.</jats:p>fibrin clot lysis time thrombolyticstroketherapybrain ischemiacovid-19emergency service, hospitalfibrinolytic agentshumansprospective studiesstrokethrombolytic therapytime-to-treatmenttissue plasminogen activatortreatment outcometenecteplasefibrinolytic agenttissue plasminogen activatoradultagedanterior cerebral arteryarticleatrial fibrillationblood clot lysisblood pressureblood vessel occlusionbrain hemorrhagecerebrovascular accidentcomputer assisted tomographycoronavirus disease 2019diabetes mellitusdiastolic blood pressureemergency wardfemalehumanhypercholesterolemiamajor clinical studymalemiddle agedmultivariate analysisnational institutes of health stroke scaleneurologistphysicianprobabilityprospective studyrankin scalerisk factorsystolic blood pressurethrombectomyunivariate analysisvery elderlybrain ischemiacerebrovascular accidentcomplicationcoronavirus disease 2019fibrinolytic therapyhospital emergency serviceprocedurestime to treatmenttreatment outcomeResource Types::text::journal::journal article