{"id":1677,"date":"2024-12-30T17:03:52","date_gmt":"2024-12-30T17:03:52","guid":{"rendered":"https:\/\/journal.nncf.kz\/?p=1677"},"modified":"2025-02-04T10:57:19","modified_gmt":"2025-02-04T10:57:19","slug":"international-practices-in-optimizing-time-metrics-for-reperfusion-therapy-in-acute-ischemic-stroke","status":"publish","type":"post","link":"https:\/\/journal.nncf.kz\/kz\/international-practices-in-optimizing-time-metrics-for-reperfusion-therapy-in-acute-ischemic-stroke\/","title":{"rendered":"INTERNATIONAL PRACTICES IN OPTIMIZING TIME METRICS FOR REPERFUSION THERAPY IN ACUTE ISCHEMIC STROKE"},"content":{"rendered":"

Received: 15.10.2024 Accepted: 01.12.2024 Published online: 30.12.2024
\nDOI 10.26212\/2227-1937.2025.62.81.014<\/a>
\n\u0423\u0414\u041a 616.831-005.4-089.168
\nINTERNATIONAL PRACTICES IN OPTIMIZING TIME METRICS FOR REPERFUSION THERAPY
\nIN ACUTE ISCHEMIC STROKE
\nShayakhmet Makhanbetkhan1, ORCID: https:\/\/orcid.org\/0000-0003-2606-4785
\nBotagoz Turdaliyeva 2, ORCID: https:\/\/orcid.org\/0000-0001-9884-0777
\nYerzhan Adilbekov3, ORCID: https:\/\/orcid.org\/0000-0002-9166-3859
\nMynzhylky Berdikhojayev4, ORCID: https:\/\/orcid.org\/0000-0003-1260-5923
\nSabina Medukhanova 3, ORCID: https:\/\/orcid.org\/0000-0002-8808-6106
\nAbzal Zhumabekov5, ORCID:https:\/\/orcid.org\/0000-0002-8508-3129
\nMarat Sarshayev 5, ORCID: https:\/\/orcid.org\/0000-0003-1757-9189
\nSharapat Moiynbayeva1*, ORCID:https:\/\/orcid.org\/0000-0003-1720-5064
\n1 Kazakhstan\u2019s Medical University \u201cKSPH\u201d, Almaty, Kazakhstan
\n2 Kazakh Scientific Center of Dermatology and Infectious Diseases, Almaty, Kazakhstan
\n3National Coordination Center for Emergency Medicine, Astana, Kazakhstan
\n4Hospital of the Medical Center of the Presidential Administration, Astana, Kazakhstan
\n5 JSC \u00abCentral Clinical Hospital\u00bb, Almaty, Kazakhstan
\n*Corresponding author:
\nSharapat Moiynbayeva, Master of Medicine, postdoctoral student at the KMU \u201cKSPH\u201d, Deputy Director of the Department of
\nScience and Consulting, Almaty, Kazakhstan.
\ne-mail: moyinbaeva@inbox.ru phone number:8 (707) 427-86-34
\nAbstract:
\nIntroduction. Acute ischemic stroke (AIS) remains one of the leading causes of mortality and long-term disability worldwide.
\nReperfusion therapy, including thrombolysis and thrombectomy, is highly time-sensitive and significantly improves patient
\noutcomes when administered promptly. However, international variations in treatment time metrics and accessibility pose
\nchallenges to optimizing outcomes globally.
\nThe aim of the review:This review aims to analyze key time metrics for reperfusion therapy, such as door-to-puncture (DTP)
\nand door-to-groin puncture (DTGP), in high- and upper-middle-income countries. It seeks to identify factors influencing
\ntreatment efficiency and outcomes to provide actionable recommendations for healthcare systems, including Kazakhstan.
\nMaterials and methods:A systematic review was conducted using PubMed, Scopus, Web of Science, and Cochrane Library
\ndatabases. Studies published between 2005 and 2021 were included, focusing on time metrics such as DTP, onset-to-needle
\n(OTN), DTGP, onset-to-groin puncture (OTGP), and onset-to-door (OTD). A total of 27 studies were selected using PRISMA
\nguidelines, and key findings were extracted for comparative analysis.
\nResults:The analysis revealed significant international variability in time metrics. Countries like Switzerland and the
\nUSA\/Canada demonstrated shorter DTP and DTGP times, correlating with higher percentages of favorable outcomes at 90 days.
\nThese metrics underscore the importance of efficient emergency services and hospital workflows. Additionally, disparities in
\naccess to advanced stroke care were identified, particularly in regions with fewer stroke centers and endovascular specialists.
\nConclusion: This review highlights the critical role of optimizing time metrics to improve patient outcomes in AIS.
\nInternational best practices, such as dual-modality approaches combining thrombolysis and thrombectomy, can serve as
\nmodels for improving stroke care efficiency. For Kazakhstan, the findings emphasize the need to reduce treatment delays by
\nenhancing prehospital systems and developing regional stroke centers. Future efforts should focus on addressing global
\ndisparities and standardizing key metrics to facilitate comparisons and improvements in care.
\nKeywords: Acute Ischemic Stroke, Reperfusion Therapy, Time-to-Treatment, Thrombolytic Therapy, Thrombectomy, Door-toPuncture Time, Door-to-Groin Time, Healthcare Disparities, Stroke Units, Treatment Outcome<\/p>\n

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