Reduction of In-hospital Delays in Stroke Thrombolysis: SITS-WATCH

Not Applicable

• Conditions: Stroke
• Interventions: Other: Reduction of DTN

• Registration Number: NCT01811901
• Lead Sponsor: SITS International

Brief Summary

In patients with acute ischemic stroke: the sooner the thrombolysis treatment is administered after symptom onset - the better the outcome. This delay can be dissected into onset-to-door time and door-to-needle time (DNT). SITS-WATCH aims to reduce median DNT in participating centres.

Detailed Description

In patients with acute ischemic stroke: the sooner the thrombolysis treatment is administered after symptom onset - the better the outcome. This delay can be dissected into onset-to-door time and door-to-needle time (DNT). Of the two, DNT can be directly influenced within the hospital by stream-lining of acute stroke care. The aim of our study is to reduce in-hospital delays (DNT) in self-selecting centers recruiting patients into the the Safe Implementation of Treatments in Stroke-International Stroke Thrombolysis Register (SITS-ISTR) , comprising currently more than 80 000 patients from 1338 centers. Current median of DNT in all SITS centers is 65 minutes (compared with 20 minutes in Helsinki Univer-sity Central Hospital). An itemized detailed questionnaire, including all factors known to influence DNT, has been sent to all SITS centers to identify the reasons for long in-hospital delays. Based on the replies, we have prepared a list of interventions that can be considered by individual SITS centers in order to reduce DNT with interventions that are in line with national legislation.

Study Timeline

• Study Start: 2013-01
• Status Verified: 2013-03
• Study First Submitted: 2013-03-12
• Study First Submitted QC: 2013-03-14
• Last Update Submitted: 2013-03-14
• Study First Posted: 2013-03-15
• Last Update Posted: 2013-03-15
• Primary Completion: 2015-06
• Study Completion: 2015-06

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 3000

Inclusion Criteria

• All consecutive patients with acute ischemic stroke registered in SITS registry.

Exclusion Criteria

• Centers not inputing patient data into SITS registry. Patients with missing DNT data.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Intervention group (SITS-WATCH centers)	Reduction of DTN	15-item list of suggested interventions aiming to reduce DNT sent to SITS-WATCH centers.

Primary Outcome Measures

Name	Time	Method
Absolute DNT reduction of at least 20 minutes or at least 20% change in SITS-WATCH centers that completed the whole study period	January 2013-December 2014	DNT will be evaluated at regular intervals (twice a year).

Secondary Outcome Measures

Name	Time	Method
Significantly larger reduction of DNT in SITS-WATCH centers compared with non-SITS-WATCH centers in SITS.	2014-2015	Proportion of centers with median DNT below 40 minutes. At least 3 new interventions implemented. Percentage of implemented interventions.

Trial Locations

Locations (1)

SITS International / Karolinska Hospital; 🇸🇪 Stockholm, Sweden