Point-of-care laboratory halves door-to-therapy-decision time in acute stroke

Silke Walter, Panagiotis Kostopoulos, Anton H. Haass, Martin Lesmeister, Mihaela Grasu, Iris Grunwald, Isabel Keller, Stefan Helwig, Carmen Becker, Juergen Geisel, Thomas Bertsch, Sarah Kaffiné, Annika Leingärtner, Panagiotis Papanagiotou, Christian Roth, Yang Liu, Wolfgang Reith, Klaus Fassbender (Lead / Corresponding author)

    Research output: Contribution to journalArticlepeer-review

    79 Citations (Scopus)

    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.

    Original languageEnglish
    Pages (from-to)581-586
    Number of pages6
    JournalAnnals of Neurology
    Volume69
    Issue number3
    Early online date14 Dec 2010
    DOIs
    Publication statusPublished - Mar 2011

    Keywords

    • Adult
    • Aged
    • Aged, 80 and over
    • Brain Ischemia/therapy
    • Decision Making
    • Female
    • Fibrinolytic Agents/therapeutic use
    • Humans
    • Male
    • Middle Aged
    • Point-of-Care Systems
    • Prospective Studies
    • Stroke/therapy
    • Thrombolytic Therapy/methods
    • Time Factors

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