BACKGROUND: With a recent surge of clinical trials, the treatment of @entity385 has undergone dramatic changes. OBJECTIVE: To evaluate the impact of evidence and a revamped @entity64 protocol on a large healthcare system. METHODS: A retrospective review of 69 @entity1 with @entity385 treated with intra-arterial therapy was carried out. Cohort 1 included @entity1 treated before implementation of a new @entity64 protocol, and cohort 2 after implementation. Angiographic outcome was graded using the Thrombolysis in @entity385 (TICI) score. Clinical outcomes were assessed using the National Institute of Health @entity64 Scale (NIHSS) and modified Rankin Scale (mRS). RESULTS: Primary outcomes comparing cohorts demonstrated decreased arrival-to-puncture time (cohort 2: 104 vs cohort 1: 181   min, p<0.001), similar TICI 2b/3 rates (86.5% vs 81.3%, p=0.5530), and similar percentage of @entity1 with discharge mRS 0-2 (18.9% vs 21.9%, p=0.7740). Notable secondary outcomes for cohort 2 included decreased puncture-to-first pass time (34 vs 53 min, p <0.001), increased TICI 3 rates (37.8% vs 18.8%, p=0.0290), a trend toward greater improvements in NIHSS on postoperative day 1 (6.8 vs 2.6, p=0.0980) and discharge (9.5 vs 6.7, p=0.1130), and a trend toward increased percentage of @entity1 discharged with mRS 0-3 (48.6% vs 34.4%, p=0.3280 NS). There were similar rates of symptomatic @entity1779 (10.8% vs 9.4%, p=0.9570) and @entity204 (10.8% vs 15.6%, p=0.5530). CONCLUSIONS: An interdisciplinary and rapid response to the emergence of strong clinical evidence can result in dramatic changes in a large healthcare system.

The impact of evidence: evolving therapy for acute XXXX in a large healthcare system.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke', 'Stroke'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity1779 :: ('MESH:D002543', 'Disease') :: ['intracerebral hemorrhage'] @entity385 :: ('MESH:D002544', 'Disease') :: ['ischemic stroke', 'Cerebral Infarction']
@entity385 :: (MESH:D002544,Disease) :: ['ischemic stroke']
