%0 Journal Article
%T Point
%A Dong-Wha Kang
%A Jeong-Ran Kook
%A Jong S Kim
%A Jung Hee Han
%A Mi-Jeong Yoon
%A Mi-Ok Choi
%A Sang-Beom Jeon
%A Seongsoo Jang
%A Seung-Bok Lim
%A Sun U Kwon
%J Hong Kong Journal of Emergency Medicine
%@ 2309-5407
%D 2019
%R 10.1177/1024907918799938
%X The confirmation of prothrombin time international normalized ratio by a central laboratory often delays intravenous thrombolysis in patients with acute ischemic stroke. We investigated the feasibility, reliability, and usefulness of point-of-care determination of prothrombin time international normalized ratio for stroke thrombolysis. Among 312 patients with ischemic stroke, 202 who arrived at the emergency room within 4.5ˋh of stroke onset were enrolled in the study. Patients with lost orders for point-of-care testing for the prothrombin time international normalized ratio or central laboratory testing for the prothrombin time international normalized ratio (nˋ=ˋ47) were excluded. We compared international normalized ratio values and the time interval from arrival to the report of test results (door-to-international normalized ratio time) between point-of-care testing for the prothrombin time international normalized ratio and central laboratory testing for the prothrombin time international normalized ratio. In patients who underwent thrombolysis, we compared the time interval from arrival to thrombolysis (door-to-needle time) between the current study population and historic cohort at our center. In the 155 patients included in the study, the median door-to-international normalized ratio time was 9.0ˋmin (interquartile range, 5.0每12.0ˋmin) for point-of-care testing for the prothrombin time international normalized ratio and 46.0ˋmin (interquartile range, 38.0每55.0ˋmin) for central laboratory testing for the prothrombin time international normalized ratio (pˋ<ˋ0.001). The intraclass correlation coefficient between point-of-care testing for the prothrombin time international normalized ratio and central laboratory testing for the prothrombin time international normalized ratio was 0.975 (95% confidence interval: 0.966每0.982). Forty-nine of the 155 patients underwent intravenous thrombolysis. The door-to-needle time was significantly decreased after implementation of point-of-care testing for the prothrombin time international normalized ratio (median, 23.0ˋmin; interquartile range, 16.0每29.8 vs median, 46.0ˋmin; interquartile range, 33.5每50.5ˋmin). Utilization of point-of-care testing for the prothrombin time international normalized ratio was feasible in the management of patients with acute ischemic stroke. Point-of-care testing for the prothrombin time international normalized ratio was quick and reliable and had a pivotal role in expediting thrombolysis
%K Cerebral infarction
%K thrombolytic therapy
%K tissue plasminogen activator
%K blood coagulation tests
%K prothrombin time
%U https://journals.sagepub.com/doi/full/10.1177/1024907918799938