Length of stay in emergency department and cerebral intravenous thrombolysis in community hospitals

Objectives: Current guidelines for the early management of patients with acute ischemic stroke recommend completion of an evaluation within 60 min of the patient’s arrival at the emergency department (ED) because prolongation of ED length of stay (LOS) may reduce the efficacy of acute stroke treatment. Aim: To evaluate the LOS in EDs at the community-based Polish stroke centers, to determine logistic, social, epidemiological, and clinical factors responsible for its prolongation, and to assess the association between increased LOS and the implementation of cerebral intravenous (IV) thrombolysis. Materials and methods: This study carried out an evaluation of the medical records of 8398 patients with stroke and transient ischemic attack who consecutively reported to the Pomeranian Stroke Registry from 2010 to 2012. Results: The median ED LOS in the studied cohort was 97 (44–196) min and was prolonged (>60 min) in 63.1% of patients. Prolongation of ED LOS contributed to a low (4.9%) IV thrombolysis rate. Functional status at discharge was worse in patients with prolonged versus nonprolonged LOS [modified Rankin scale: 2 (0–3) vs. 1 (0–3) points; P

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