Impact of Optimizing the Emergency Green Channel on Intravenous Thrombolysis Outcomes for Acute Ischemic Stroke in a Primary-Level Hospital

LI Weicheng; WEI Gaojin

doi:10.13919/j.issn.2095-6274.ZHJY202506044

Abstract：Objective To investigate the impact of optimizing the emergency green channel on intravenous throm-bolysis in patients with acute ischemic stroke in a primary-level hospital.Methods A total of 84 patients with acute ischemic stroke treated at Zhouning County Hospital,Fujian Province,from December 2022 to December 2024 were en-rolled.Using a random number table,patients were assigned to an observation group(optimized green-channel pathway)or a control group(conventional emergency pathway),with 42 cases in each.The two groups were compared with respect to the efficiency of key emergency processes,severity of neurological deficit,activities of daily living(ADL),treatment out-comes,adverse events.Results Compared with the control group,the observation group had significantly shorter times for arrival-to-first medical contact,first medical contact-to-consultation activation,first medical contact-to-CT,first medical contact-to-blood draw,signature-to-medication,stroke team arrival,family decision-making,and door-to-needle time for intravenous thrombolysis(P＜0.001).Emergency department length of stay was also significantly shorter in the observation group(P=0.003).Before treatment,there were no significant differences between groups in NIHSS(neurological deficit)or ADL scores(both P＞0.05).After treatment,both groups showed significant decreases in NIHSS scores(P＜0.001)and significant increases in ADL scores(P＜0.001);the ob-servation group demonstrated greater reductions in NIHSS(P＜0.001)and greater improvements in ADL(P＜0.001).The success rate of emergency rescue did not differ significantly between groups(P=0.137).The observation group had significantly lower recurrence(P=0.043),disability rates(P=0.048)and the total incidence of adverse events(P=0.019),and a shorter hospital length of stay(P＜0.001),compared with the control group.Conclusion In the emergency management of acute ischemic stroke at primary-level hospitals,optimiz-ing the emergency green channel shortens door-to-needle time,effectively enhances emergency efficiency and treatment effectiveness,improves neurological function and activities of daily living,and reduces the risk of adverse events.