J 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.