{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T13:58:51Z","timestamp":1784728731646,"version":"3.55.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>In the United States, about half of acute ischemic stroke patients treated with tPA (tissue-type plasminogen activator) receive treatment within 60 minutes of hospital arrival. We aimed to determine the proportion of patients receiving tPA within 60 minutes (door-to-needle time [DTNT] \u226460) and 45 minutes (DTNT \u226445) of hospital arrival by race\/ethnicity and sex and to identify temporal trends in DTNT \u226460 and DTNT \u226445.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>Among 65\u2009654 acute ischemic stroke admissions in the National Institute of Neurological Disorders and Stroke-funded FL-PR CReSD study (Florida-Puerto Rico Collaboration to Reduce Stroke Disparities) from 2010 to 2015, we included 6181 intravenous tPA-treated cases (9.4%). Generalized estimating equations were used to determine predictors of DTNT \u226460 and DTNT \u226445.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>DTNT \u226460 was achieved in 42% and DTNT \u226445 in 18% of cases. After adjustment, women less likely received DTNT \u226460 (odds ratio, 0.81; 95% confidence interval, 0.72\u20130.92) and DTNT \u226445 (odds ratio, 0.73; 95% confidence interval, 0.57\u20130.93). Compared with Whites, Blacks less likely had DTNT \u226445 during off hours (odds ratio, 0.68; 95% confidence interval, 0.47\u20130.98). Achievement of DTNT \u226460 and DTNT \u226445 was highest in South Florida (50%, 23%) and lowest in West Central Florida (28%, 11%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In the FL-PR CReSD, achievement of DTNT \u226460 and DTNT \u226445 remains low. Compared with Whites, Blacks less likely receive tPA treatment within 45 minutes during off hours. Treatment within 60 and 45 minutes is lower in women compared with men and lowest in West Central Florida compared with other Florida regions and Puerto Rico. Further research is needed to identify reasons for delayed thrombolytic treatment in women and Blacks and factors contributing to regional disparities in DTNT.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.116.016183","type":"journal-article","created":{"date-parts":[[2017,7,14]],"date-time":"2017-07-14T01:10:37Z","timestamp":1499994637000},"page":"2192-2197","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":43,"title":["Disparities and Trends in Door-to-Needle Time"],"prefix":"10.1161","volume":"48","author":[{"given":"Sofia A.","family":"Oluwole","sequence":"first","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kefeng","family":"Wang","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuanhui","family":"Dong","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria A.","family":"Ciliberti-Vargas","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina M.","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Yi","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose G.","family":"Romano","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enmanuel","family":"Perez","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany Ann","family":"Tyson","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maranatha","family":"Ayodele","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Negar","family":"Asdaghi","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Gardener","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Z.","family":"Rose","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enid J.","family":"Garcia","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Zevallos","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dianne","family":"Foster","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Robichaux","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salina P.","family":"Waddy","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph L.","family":"Sacco","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatjana","family":"Rundek","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, University of Miami Miller School of Medicine, FL (S.A.O., K.W., C.D., M.A.C.-V., C.M.G., L.Y., J.G.R., E.P., B.A.T., M.A., N.A., H.G., R.L.S., T.R.); Department of Neurology, University of South Florida Morsani College of Medicine, Tampa (D.Z.R.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (S.P.W.); The American Heart Association, Greater Southeast Affiliate, Marietta, GA (D.F., M.R.); and Florida International University Herbert..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000350"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000152"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0804656"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000196957.55928.ab"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.3203"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.6959"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2015.12.025"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.974675"},{"key":"e_1_3_3_10_2","unstructured":"Target: Stroke Honor Roll - Recognition for Your Success. The American Heart Association Website. http:\/\/www.strokeassociation.org\/STROKEORG\/Professionals\/TargetStroke\/Target-Stroke-Honor-Roll\u2014Recognition-For-Your-Success_UCM_432416_Article.jsp#.WNQYQIWcHIV. 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The American Heart Association Website. https:\/\/www.heart.org\/HEARTORG\/Professional\/HospitalAccreditationCertification\/ComprehensiveStrokeCenterCertification\/Comprehensive-Stroke-Center-Certification_UCM_455446_SubHomePage.jsp. Accessed on September 12 2016."},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-016-8076-5"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.613828"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.32.5.1061"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000203335.45804.72"},{"key":"e_1_3_3_24_2","unstructured":"American Heart Association; Clinical Resources and Tools. Target: Stroke Phase II Manual 11 Key Best Practice Strategies. https:\/\/www.heart.org\/idc\/groups\/heart-public\/@wcm\/@mwa\/documents\/downloadable\/ucm_486394.pdf. 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In press.","journal-title":"South Med J"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.116.016183","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T15:23:07Z","timestamp":1715613787000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.116.016183"}},"subtitle":["The FL-PR CReSD Study (Florida-Puerto Rico Collaboration to Reduce Stroke Disparities)"],"short-title":[],"issued":{"date-parts":[[2017,8]]},"references-count":26,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2017,8]]}},"alternative-id":["10.1161\/STROKEAHA.116.016183"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.116.016183","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8]]},"assertion":[{"value":"2016-12-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-05-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-07-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}