Objective To investigate the influential factors for in-hospital delay of recombinant tissue
plasminogen activator (rt-PA) for acute ischemic stroke in multi-center primary hospital.
Methods Patients in nine basic-level hospitals in Taizhou treated with rt-PA intravenous
thrombolytic within 4.5 hours after stroke onset were collected into this study. Based on the doorto-
needle time (DNT) on average and the DNT less or more than 60 minutes, patients were divided
into two groups, and then the independent factors associated with the DNT was analyzed.
Results The mean DNT of 28 patients is (79.50±26.97 min). As compared to the DNT>79.50 minutes
group, delay in admission to the stroke team acception (P =0.007), to the conversation (P <0.001), to reaching the wards (P <0.001), and to CT examination (P <0.001) were shorter, history of hypertension
(P =0.049), hyperlipidemia (P =0.007), and atrial fibrillation were smaller (P =0.022). And as compared
to the DNT>60 min group, delay in admission to CT examination (P =0.025), to the conversation
(P <0.001), to reaching the wards (P <0.001), and delay in CT examination to drug using (P <0.001), to
the laboratory results were shorter (P =0.009), blood glucose was relatively lower (P =0.001), history
of diabetes (P =0.001) and hyperlipidemia (P =0.030) were smaller. Logistic regression analysis
showed that delay in admission to CT examination (OR=0.954, 95%CI 0.917~0.992, P =0.005), to the
conversation (OR=0.501, 95%CI 0.320~0.781, P =0.003), to reaching the wards (OR=0.925, 95%CI
0.886~0.970, P =0.010) and delay in CT examination to drug using (OR=0.796, 95%CI 0.620~0.982,
P =0.005), to the laboratory results (OR=0.496, 95%CI 0.312~0.804, P =0.037), and blood glucose
(OR=0.610, 95%CI 0.281~0.969, P =0.017) lead to longer DNT.
Conclusion The time between admission to CT examination, to the conversation, to reaching the
wards and CT examination to drug using, to the laboratory results, and also the blood glucose are
the main factors influencing the DNT.
