Enhancing Thrombolysis Times in Acute Ischemic Stroke With Regional Dashboards: Results From the Florida Stroke Registry
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Reducing time to intravenous thrombolysis (IVT) is crucial for effective ischemic stroke treatment. Through grassroots efforts, the FSR (Florida Stroke Registry) developed regional dashboards (RDs) displaying reperfusion metrics within local Stroke Coalitions to improve acute stroke care quality. We sought to evaluate whether RD use is associated with faster IVT times and improved hospitalization outcomes. METHODS: We compared IVT-treated cases of ischemic stroke at FSR hospitals participating in the RD initiative versus nonparticipating hospitals from January 2016 to December 2023. Primary outcomes were door-to-treatment time <20 minutes and onset-to-treatment time <60 minutes. Secondary outcomes included intracerebral hemorrhage after IVT, discharge disposition, and in-hospital death. Logistic regression models, adjusted for calendar year, patient characteristics, and hospital factors, assessed the association between RD use and study outcomes. RESULTS: By the end of the study period, 92 of 172 FSR hospitals (53.5%) were participating in stroke coalitions and using RDs. Among 32 320 IVT-treated cases (mean age, 69±15 years, 48.4% women), 10 666 (33.0%) were treated in RD-participating hospitals. RD participation was independently associated with door-to-treatment time <20 minutes (12.7% versus 7.3%; adjusted odds ratio, 1.48 [95% CI, 1.35-1.63]) and onset-to-treatment time <60 minutes (13.9% versus 9.0%; adjusted odds ratio, 1.63 [95% CI, 1.49-1.80]), as well as increased likelihood of being discharged directly to home (adjusted odds ratio, 1.15 [95% CI, 1.07-1.23]). CONCLUSIONS: The implementation of the FSR RD initiative within stroke coalitions was associated with faster IVT times and higher likelihood of home discharge. This quality improvement initiative, adaptable to local needs, could emerge as a valuable tool for enhancing stroke systems of care.
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,810
Awards: Disparities in Transition of Care after Acute Stroke Hospitalization: The Transition of Care Stroke Disparity Study (TCSD-S), Family Study of Carotid Atherosclerosis and Stroke Risk, 1Florida Alzheimer's Disease Research Center, Risk Factors for Stroke and Cognitive Decline in a Tri-Ethnic Region, Miami Clinical and Translational Science Institute, Hispanic Stroke Prevention Intervention Research Program, Study of Latinos-Investigation of Neurocognitive Aging-Alzheimer's disease, Innovative Deep Phenotyping of African Americans at Risk for Alzheimers disease, Florida Regional Coordinating Center for the NINDS Stroke Trials Network, Precision Aging Network: Closing the Gap Between Cognitive Healthspan andHuman Lifespan, Miami Clinical and Translational Science Institute K12 Program, The role of PFAS in lipid-mediated vascular contributions to cognitive impairment and dementia: PFAS VascCog Longitudinal Study, Program to Increase Diversity in Behavioral Medicine and Sleep Disorders Research, Psycho-neuro-immune Mechanisms Linking Stigma and Discrimination to Carotid Plaque Formation in Persons living with HIV, The Clinical Significance of Incidental White Matter Lesions on MRI Amongst a Diverse Population with Cognitive Complaints (INDEED)
OpenAlex ID: W4410328200