Off-hours effects of endovascular treatment for acute ischemic stroke:a retrospective study based on a senior stroke center
Objective To investigate whether there is an off-hours effect on the endovascular treatment(EVT)process for patients with acute ischemic stroke(AIS)after emergency admission to the hospital.Methods We retrospectively analyzed AIS patients who were admitted to the West China Hospital of Sichuan University on the stroke green channel between September 2019 and August 2023 and planned to perform emergency EVT.The patients were divided into working-hour and off-hour groups according to their admission time.The clinical information,door-to-puncture time(DPT),door-to-head/neck imaging time(DIT)and door-to-blood test time(DBT)of the two groups patients were compared,and subgroup analysis was conducted according to whether they arrived at the hospital at night,before and after the guideline update,and whether they were in the coronavirus disease 2019 epidemic period.Results A total of 586 AIS patients with large vessel occlusion were included,including 220 patients admitted during working hours and 336 patients admitted during off-working hours.There was no statistically significant difference in the basic information and EVT process time between patients admitted during working hours and patients admitted during off-working hours(P＞0.05).Subgroup analysis showed that in patients admitted during off-working hours,there was no statistically significant difference in the basic information and EVT process time between patients arrived at the hospital at night and patients did not arrive at the hospital at night(P＞0.05).Before and after the guideline updated,there was no statistically significant difference in the basic information and EVT process time between patients admitted during working hours and patients admitted during off-working hours(P＞0.05).No matter whether it is in the coronavirus disease 2019 epidemic period,there was no statistically significant difference in the basic information and EVT process time between patients admitted during working hours and patients admitted during off-working hours(P＞0.05).Conclusions There is no off-hours effect on the EVT process time after AIS patients arrive at the hospital.In the future,more stroke centers of different levels are needed to further explore the impact of off-hours effect on emergency diagnosis and treatment of AIS patients.
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