Association of Component Strategies of the Target Stroke Phase 3 Nationwide Quality Improvement Program With Accelerated Door-to-Puncture and Door-In-Door-Out Times for Ischemic Stroke Endovascular Thrombectomy in the United States

作者：Brian Mac Grory, Kaiz Asif, Haolin Xu, Brooke Alhanti, Jay B. Lusk, David Hasan, Soojin Park, Amelia K. Boehme, Kori S. Zachrison, Mayank Goyal, Andrew M. Southerland, Ashutosh P. Jadhav, Santiago Ortega‐Gutiérrez, Ameer E Hassan, Kyle M Fargen, Kevin N. Sheth, Edward C. Jauch, Ying Xian, Eric D. Peterson, Eric E. Smith, Steven R. Messé, Lee H. Schwamm, Peter D. Panagos, Charles Wira, Jeffrey L. Saver, Gregg C. Fonarow · 发表于：Circulation Cardiovascular Quality and Outcomes · 年份：2025 · DOI：10.1161/circoutcomes.125.012456 · 被引用次数：3 · 研究领域：Acute Ischemic Stroke Management、Venous Thromboembolism Diagnosis and Management、Hospital Admissions and Outcomes

BACKGROUND: The Target Stroke Phase III program is a national quality improvement initiative led by the American Heart Association, which sought to improve the quality of care for patients with acute stroke undergoing acute reperfusion therapy including endovascular thrombectomy (EVT). METHODS: A retrospective, observational cohort study was performed using data from the American Heart Association Get With The Guidelines-Stroke Program between January 1, 2017, and March 31, 2022. Three categories of patients were analyzed: (1) patients who arrived directly at the thrombectomy hospital and had EVT, (2) patients who were transferred in from a nonthrombectomy hospital and had EVT, and (3) patients at a nonthrombectomy hospital who were potentially eligible for EVT, received intravenous thrombolysis, and were transferred out. The primary end point of this study for thrombectomy hospitals was door-to-puncture time. RESULTS: In direct-arriving EVT patients, 2 Target Stroke Phase III strategies were independently associated with shorter door-to-puncture time: (1) alerting the neurointerventional team based on emergency medical services prenotification (-21.9 [95% CI, -42.5 to -1.3] minutes) and (2) performance of a brain computed tomography and computed tomography angiography in all patients presenting ≤24 hours from time last known well (-6.6 [95% CI, -11.8 to -1.5] minutes). In transfer-in EVT patients, 2 Target Stroke Phase III strategies were independently associated with a shor...