Door-to-Needle Times

See related article, p 1275. In this issue of Stroke, Strbian et al1 present disappointing data on door-to-needle times (DNTs) for tissue-type plasminogen activator (tPA) from the Safe Implementation of Thrombolysis in Stroke (SITS) registry. Not only was the median DNT 67 minutes long, but also there was little overall change from 2003 to 2011 (see Figure 1 of Strbian et al1). This means that more than half of patients were treated >60 minutes after emergency department arrival, an unacceptably long interval.DNTs in North America in this time period were slightly longer. In the US national Get With The Guidelines-Stroke (GWTG-Stroke) database, median DNT from 2003 to 2009 was 78 minutes.2 In the Registry of the Canadian Stroke Network, median DNT from 2008 to 2009 was 72 minutes.3However, hidden within these overall disappointing data there is a glimmer of hope. The largest volume hospitals in SITS, treating >75 to 100 patients …