What time goals should be placed on the delivery of reperfusion therapy to the individual patient?
Greatest emphasis should be placed on the delivery of reperfusion therapy to the individual patient as rapidly as possible. Only a minority of US hospitals are capable of performing and any delay in time to reperfusion (D2B) after hospital arrival is associated with a higher adjusted risk of in-hospital mortality in a continuous, nonlinear fashion. Strict time goals for reperfusion may not always be relevant or possible for patients who have an appropriate reason for delay, including initial uncertainty about diagnosis, the need for evaluation and treatment of other life-threatening conditions (eg, acute respiratory failure, cardiac arrest), delays involving informed consent, and long transport times due to geographic distance or adverse weather.