2017
Intravenous thrombolysis for patients with in-hospital stroke onset: propensity-matched analysis from the Safe Implementation of Treatments in Stroke-East registry
TSIVGOULIS, G., A.H. KATSANOS, P. KADLECOVA, A. CZLONKOWSKA, A. KOBAYASHI et. al.Základní údaje
Originální název
Intravenous thrombolysis for patients with in-hospital stroke onset: propensity-matched analysis from the Safe Implementation of Treatments in Stroke-East registry
Autoři
TSIVGOULIS, G. (300 Řecko), A.H. KATSANOS (300 Řecko), P. KADLECOVA (203 Česká republika), A. CZLONKOWSKA (616 Polsko), A. KOBAYASHI (616 Polsko), M. BROZMAN (703 Slovensko), V. SVIGELJ (705 Slovinsko), L. CSIBA (348 Maďarsko), K. FEKETE (348 Maďarsko), J. KORV (233 Estonsko), V. DEMARIN (191 Chorvatsko), A. VILIONSKIS (440 Litva), D. JATUZIS (440 Litva), Y. KRESPI (792 Turecko), T. KARAPANAYIOTIDES (300 Řecko), S. GIANNOPOULOS (300 Řecko) a Robert MIKULÍK (203 Česká republika, garant, domácí)
Vydání
European Journal of Neurology, Oxford, Rapid Science Ltd. 2017, 1351-5101
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30210 Clinical neurology
Stát vydavatele
Spojené státy
Utajení
není předmětem státního či obchodního tajemství
Impakt faktor
Impact factor: 4.621
Kód RIV
RIV/00216224:14110/17:00099191
Organizační jednotka
Lékařská fakulta
UT WoS
000415723800016
Klíčová slova anglicky
acute ischaemic stroke; door-to-needle time; in-hospital stroke; intravenous thrombolysis; onset-to-treatment time; stroke awareness
Štítky
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 21. 3. 2018 18:15, Soňa Böhmová
Anotace
V originále
Background and purposeRecent cross-sectional study data suggest that intravenous thrombolysis (IVT) in patients with in-hospital stroke (IHS) onset is associated with unfavorable functional outcomes at hospital discharge and in-hospital mortality compared to patients with out-of-hospital stroke (OHS) onset treated with IVT. We sought to compare outcomes between IVT-treated patients with IHS and OHS by analysing propensity-score-matched data from the Safe Implementation of Treatments in Stroke-East registry. MethodsWe compared the following outcomes for all propensity-score-matched patients: (i) symptomatic intracranial hemorrhage defined with the safe implementation of thrombolysis in stroke-monitoring study criteria, (ii) favorable functional outcome defined as a modified Rankin Scale (mRS) score of 0-1 at 3 months, (iii) functional independence defined as an mRS score of 0-2 at 3 months and (iv) 3-month mortality. ResultsOut of a total of 19 077 IVT-treated patients with acute ischaemic stroke, 196 patients with IHS were matched to 5124 patients with OHS, with no differences in all baseline characteristics (P > 0.1). Patients with IHS had longer door-to-needle [90 (interquartile range, IQR, 60-140) vs. 65 (IQR, 47-95) min, P < 0.001] and door-to-imaging [40 (IQR, 20-90) vs. 24 (IQR, 15-35) min, P < 0.001] times compared with patients with OHS. No differences were detected in the rates of symptomatic intracranial hemorrhage (1.6% vs. 1.9%, P = 0.756), favorable functional outcome (46.4% vs. 42.3%, P = 0.257), functional independence (60.7% vs. 60.0%, P = 0.447) and mortality (14.3% vs. 15.1%, P = 0.764). The distribution of 3-month mRS scores was similar in the two groups (P = 0.273). ConclusionsOur findings underline the safety and efficacy of IVT for IHS. They also underscore the potential of reducing in-hospital delays for timely tissue plasminogen activator delivery in patients with IHS.