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ACUTE ISCHAEMIC STROKE TREATMENT AT AORN CARDARELLI, NAPLES. A RETROSPECTIVE ANALYSIS OF THE FIRST 250 PATIENTS

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ESOC-2019

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ACUTE ISCHAEMIC STROKE TREATMENT AT AORN CARDARELLI, NAPLES. A RETROSPECTIVE ANALYSIS OF THE FIRST 250 PATIENTS Candelaresi P, Alfieri G, Andreone V, Di Iorio W, Maniscalco G, Manzo V, Napolitano M, Ranieri A, Renna R, Rippa R, Servillo G, and Florio C Neurology & Stroke Unit, AORN Antonio Cardarelli, via Cardarelli 9, 80131, Naples, Italy Corresponding author: Paolo Candelaresi, Neurology & Stroke Unit, AORN Antonio Cardarelli, via Cardarelli 9, 80131, Naples, Italy. Email: paolo.candelaresi@aocardarelli.it Phone +393484220987 Introduction The widespread availability of acute stroke treatments has historically been patchy expecially in the South of Italy. Here we present the analysis of the first year of acute ischaemic stroke treatment at AORN Cardarelli Hospital, Naples, Italy. Materials and Methods Data regarding the first 250 consecutive patients (female 49.6%) undergone reperfusion treatments since August 2017, to December 2018. We analysed: 1) number and percentage of patients admitted to our ward treated with acute therapies; 2) pre-hospital and in-hospital delays; 3) early outcome defined as the DeltaNIHSS score between admission and discharge; 4) complications. A subgroup analysis demonstrates trends in time. Results 2017 2018 Number of treated patients 39(28.2%) 211(45.1%) IVT 29(74.3%) 116(55%) Bridgings 2(5.1%) 54(25.6%) Primary EVT 8(20.5%) 41(19.4%) Prehospital delay(IQR) 71 min(53-149) 100 min(67-142) Basal NIHSS(IQR) 14(11-16) 12(7-18) Door-to-needle time(IQR) 107(88-172) 80(59-111) Door-to-Groin time(IQR) 191(150-260) 138(117-186) Discharge NIHSS(IQR) 7(3-14) 3(0-10) Wake-up/unwitnessed 1(2.5%) 24(11.3%) Delta-NIHSS between admission and discharge was statistically significant (p<0.05). The year 2018 was divided in 4 trimesters. Jan-March Apr-June July-Sept Oct-Dec Door-to-needle 117 87 63 78 P<0.05 Door-to-Groin 167 140 126 135 Pns Complications: SICH 15(6%) Fatal ICH 7(2.8%) Angioedema 1(0.5%) Arterial dissection 1(0.9%) Arterial perforation 1(0.9%) 90-days-mRS was available for 30% of patients: of them, 54.8% were independent (mRS 0-2), whereas 30% were dead. Discussion This analysis showed the increase in the number of patients treated with acute reperfusion therapies since August 2017. Accordingly, the in-hospital delays progressively and significantly lowered. Further lowering of in-hospital delays and patients’ loss at follow-up are the coming objectives.

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