Each 15-minute reduction in door-to-puncture time for endovascular thrombectomy significantly boosts patient-reported quality of life in acute ischemic stroke, according to a recent study.
A secondary analysis of the ESCAPE-NA1 trial, published in JAMA Neurology, shows that expedited endovascular thrombectomy significantly enhances patient-reported outcomes in acute ischemic stroke. The study analyzed 1,043 patients, revealing that each 15-minute reduction in door-to-puncture time improves quality of life across multiple domains.
The trial, which enrolled patients from March 2017 to August 2019, found that a median door-to-puncture time of 59 minutes resulted in a 0.03 increase in EQ-5D-5L index scores per 15 minutes of earlier treatment (95% CI, 0.02-0.04). Faster EVT also improved quality-adjusted life years by 0.29 per 15 minutes (95% CI, 0.08-0.49) and the EQ-VAS score by 1.65 (95% CI, 0.56-2.72).
Patients treated within 60 minutes of hospital arrival had significantly higher odds of reporting no or slight problems in mobility (adjusted OR, 2.59), self-care (adjusted OR, 2.42), usual activities (adjusted OR, 2.00), pain or discomfort (adjusted OR, 1.49), and anxiety or depression (adjusted OR, 2.12).
Researchers noted these findings underscore the importance of optimizing in-hospital processes to minimize EVT delays and improve patient-centered care.
The ESCAPE-NA1 trial was funded by the Canadian Institutes of Health Research, NoNO Inc, and Alberta Innovates. A full list of author disclosures can be found in the original study.