Applied Research Of Information-based And Process-optimized Emergency Green Channel On Patients With Acute Ischemic Stroke And Analysis On The Factors Influencing DNT>45min

Objective: To investigate the application value of information-based,process-optimized emergency green channel in patients with acute ischemic stroke(AIS)and the factors affecting of DNT > 45 min.Methods:1.The clinical data of 280 cases of AIS patients who underwent intravenous thrombolysis and admitted through Handan Central Hospital AIS emergency green channel from August 2020 to March 2022 were retrospectively studied.Taking the establishment of the information platform for Critically ill patients from Wuhan Easy Diagnosis Biomedicine Co.2.as the node,Patients were divided into experimental group and control group.The basic data,time points,neurological function,independence,safety,correlation between ODT and DNT collected from the two groups were analyzed.2.According to DNT,118 AIS patients from experimental group were divided into DNT≤45min group(n=73)and DNT>45min group(n=45),the clinical data of the two groups were taken into univariate analysis.Taking DNT>45min as the dependent variable and the factors with P<0.05 in univariate analysis as the independent variable,multivariate Logistic regression was used to determine the independent influencing factors of DNT>45min.Results:1.There was no significant difference in basic data between two groups(all P>0.05).2.Compared with the control group,the DNT of AIS patients in the experimental group was significantly shorter,and the proportion of patients with DNT≤60 min and DNT≤45 min in the experimental group increased(all P<0.05).3.Compared with the baseline level,the NIHSS score decreased at 24h、7d after intravenous thrombolysis,while the proportion of m RS scoring 0～2increased at 24h、7d after thrombolysis in both groups(P<0.001).The NIHSS scores and the proportion of m RS scoring 0～2 at 24h、7d after intravenous thrombolysis were the same in the two groups,and the incidences of symptomatic intracranial hemorrhage,pulmonary infection,gastrointestinal bleeding and mortality in 7 days after intravenous thrombolysis were the same with no significant difference(P>0.05).4.There was significant negative correlation between ODT and DNT in the control group(P<0.001),but no correlation between ODT and DNT in the experimental group(P>0.05).5.Compared with DNT>45min group,the proportion of patients with emergency hypotension and self-admission in DNT≤45min group decreased;the proportion of patients with stroke/TIA history,time from admission to completion of CT examination≤25min,time from admission to the arrival of the stroke team in the emergency department≤20min,informed consent time≤5min in DNT≤45min group increased significantly,which was statistically significant(all P<0.05).There was no significant difference in other clinical data(all P>0.05).6.Multivariate Logistic regression analysis showed that for patients with emergency hypotension,DNT>45min were more likely to occur,while for patients with previous stroke/TIA history and informed consent time≤5minutes,DNT>45min were less likely to occur(all P<0.05).Conclusions:1.The information-based,process-optimized AIS emergency green channel can shorten DNT,weaken the influence of ODT on DNT,and improve green channel efficiency.2.Intravenous thrombolysis can improve the early neurological function of patients with AIS and increase the proportion of good short-term prognosis.3.Patients with stroke/TIA history and shorter informed consent time were less likely to encounter DNT>45 minutes,while patients with emergency hypotensive treatment were more likely to encounter DNT>45min.