Door-to-needle time in acute stroke treatment and the “July effect”

Maximiliano A. Hawkes, Federico Carpani, Mauricio F. Farez, Sebastian F. Ameriso

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Intravenous thrombolysis improves outcomes in acute ischemic stroke in a time-dependent fashion. As in teaching hospitals, clinical outcomes may worsen due to the arrival of new inexperienced house staff early in the academic year (July effect, JE), we evaluated the impact of the “JE” on the door-to-needle time for intravenous thrombolysis and other stroke outcomes. In this retrospective cohort study, we assessed all acute ischemic strokes treated with intravenous thrombolysis between July 2003 and June 2016. Among 101 patients, there was no detrimental July effect on the door-to-needle time, rate of thrombolysis within 60 minutes of arrival, thrombolysis of stroke mimics, post-thrombolysis intracranial hemorrhages, National Institutes of Health Stroke Scale, and modified Rankin Scale outcomes.

Original languageEnglish (US)
Pages (from-to)24-28
Number of pages5
JournalThe Neurohospitalist
Issue number1
StatePublished - Jan 2018
Externally publishedYes


  • House staff
  • Stroke
  • Thrombolytic therapy

ASJC Scopus subject areas

  • Clinical Neurology


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