How Fast is Fast Enough? Assessing Door-to-Needle Times and Outcomes of Stroke Patients Receiving Acute Thrombolysis Therapy Under the Kaiser Permanente Northern California Stroke EXPRESS Program

With stroke treatment, there is a general belief that “time is brain.” However, there has been no published data examining specifically the association between door-to-needle times for acute treatment with intravenous alteplase in stroke patients and 90-day outcomes. In 2016, the Kaiser Permanente Northern California Stroke EXPRESS program rolled out at all 21 primary stroke centers with significant improvement in door-to-needle times. This study has two major aims: 1) to determine if there is an association between door-to-needle times and mortality at discharge and at 90-day post-treatment in patients who receive acute thrombolysis treatment with intravenous alteplase at Kaiser Permanente Northern California, and 2) to determine if there is an association between door-to-needle times and 90-day favorable functional outcome (defined as mRS 0-2) in patients who receive acute thrombolysis treatment with intravenous alteplase at Kaiser Permanente Northern California.

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