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@article{1402179,
author = {Tsivgoulis, G. and Katsanos, A.H. and Kadlecova, P. and Czlonkowska, A. and Kobayashi, A. and Brozman, M. and Svigelj, V. and Csiba, L. and Fekete, K. and Korv, J. and Demarin, V. and Vilionskis, A. and Jatuzis, D. and Krespi, Y. and Karapanayiotides, T. and Giannopoulos, S. and Mikulík, Robert},
article_location = {Oxford},
article_number = {12},
doi = {http://dx.doi.org/10.1111/ene.13450},
keywords = {acute ischaemic stroke; door-to-needle time; in-hospital stroke; intravenous thrombolysis; onset-to-treatment time; stroke awareness},
language = {eng},
issn = {1351-5101},
journal = {European Journal of Neurology},
title = {Intravenous thrombolysis for patients with in-hospital stroke onset: propensity-matched analysis from the Safe Implementation of Treatments in Stroke-East registry},
volume = {24},
year = {2017}
}
TY - JOUR
ID - 1402179
AU - Tsivgoulis, G. - Katsanos, A.H. - Kadlecova, P. - Czlonkowska, A. - Kobayashi, A. - Brozman, M. - Svigelj, V. - Csiba, L. - Fekete, K. - Korv, J. - Demarin, V. - Vilionskis, A. - Jatuzis, D. - Krespi, Y. - Karapanayiotides, T. - Giannopoulos, S. - Mikulík, Robert
PY - 2017
TI - Intravenous thrombolysis for patients with in-hospital stroke onset: propensity-matched analysis from the Safe Implementation of Treatments in Stroke-East registry
JF - European Journal of Neurology
VL - 24
IS - 12
SP - 1493-1498
EP - 1493-1498
PB - Rapid Science Ltd.
SN - 13515101
KW - acute ischaemic stroke
KW - door-to-needle time
KW - in-hospital stroke
KW - intravenous thrombolysis
KW - onset-to-treatment time
KW - stroke awareness
N2 - 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.
ER -
TSIVGOULIS, G., A.H. KATSANOS, P. KADLECOVA, A. CZLONKOWSKA, A. KOBAYASHI, M. BROZMAN, V. SVIGELJ, L. CSIBA, K. FEKETE, J. KORV, V. DEMARIN, A. VILIONSKIS, D. JATUZIS, Y. KRESPI, T. KARAPANAYIOTIDES, S. GIANNOPOULOS and Robert MIKULÍK. Intravenous thrombolysis for patients with in-hospital stroke onset: propensity-matched analysis from the Safe Implementation of Treatments in Stroke-East registry. \textit{European Journal of Neurology}. Oxford: Rapid Science Ltd., vol.~24, No~12, p.~1493-1498. ISSN~1351-5101. doi:10.1111/ene.13450. 2017.
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