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@article{1454956,
author = {Tsivgoulis, Georgios and Geisler, Frederik and Katsanos, Aristeidis H. and Korv, Janika and Kunz, Alexander and Mikulík, Robert and Rozanski, Michal and Wendt, Matthias and Audebert, Heinrich J.},
article_location = {Dallas},
article_number = {8},
doi = {http://dx.doi.org/10.1161/STROKEAHA.118.021536},
keywords = {intracranial hemorrhages; reperfusion; stroke; acute; thrombolytic therapy},
language = {eng},
issn = {0039-2499},
journal = {Stroke},
title = {Ultraearly Intravenous Thrombolysis for Acute Ischemic Stroke in Mobile Stroke Unit and Hospital Settings: A Comparative Analysis},
volume = {49},
year = {2018}
}
TY - JOUR
ID - 1454956
AU - Tsivgoulis, Georgios - Geisler, Frederik - Katsanos, Aristeidis H. - Korv, Janika - Kunz, Alexander - Mikulík, Robert - Rozanski, Michal - Wendt, Matthias - Audebert, Heinrich J.
PY - 2018
TI - Ultraearly Intravenous Thrombolysis for Acute Ischemic Stroke in Mobile Stroke Unit and Hospital Settings: A Comparative Analysis
JF - Stroke
VL - 49
IS - 8
SP - 1996-1999
EP - 1996-1999
PB - Lippincott Williams & Wilkins
SN - 00392499
KW - intracranial hemorrhages
KW - reperfusion
KW - stroke
KW - acute
KW - thrombolytic therapy
N2 - Background and Purpose Mobile stroke units (MSUs) are known to increase the proportion of acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT) in the first golden hour (GH) after onset compared with hospital settings (HS). However, because of the low number of AIS patients treated with intravenous thrombolysis within this ultraearly time window in conventional care, characteristics, and outcome of this subgroup of AIS patients have not been compared between MSU and HS. Methods MSU-GH patients were selected from the Berlin-based MSU (STEMO [Stroke Emergency Mobile]), whereas HS-GH patients were selected from the SITS-EAST (Safe Implementation of Treatments in Stroke-East) registry. The outcome events of interest included the rates of favorable functional outcome (modified Rankin Scale scores of 0 or 1), distribution of the modified Rankin Scale scores, and mortality after 3 months between MSU-GH and HS-GH groups. Results We identified 117 MSU-GH (38.4% of 305 MSU-treated patients) and 136 HS-GH (0.9% of 15591 HS-treated patients) eligible patients without prestroke disability. No significant differences were documented in the rates of favorable functional outcome (51.3% versus 46.2%, P=0.487) and mortality (7.7% versus 9.9%, P=0.576) at 3 months, or in the distribution of 3-month modified Rankin Scale scores between the 2 groups (P=0.196). In multivariable logistic regression analyses, adjusting for potential confounders, MSU treatment was not associated with a significantly different likelihood of favorable functional outcome (odds ratio, 1.84 for MSU patients; 95% CI, 0.86-3.96) or mortality (odds ratio, 0.95; 95% CI, 0.28-3.20) at 3 months. Conclusions There is no evidence that safety and efficacy of ultraearly intravenous thrombolysis for AIS differs when used in MSUs or in HS.
ER -
TSIVGOULIS, Georgios, Frederik GEISLER, Aristeidis H. KATSANOS, Janika KORV, Alexander KUNZ, Robert MIKULÍK, Michal ROZANSKI, Matthias WENDT a Heinrich J. AUDEBERT. Ultraearly Intravenous Thrombolysis for Acute Ischemic Stroke in Mobile Stroke Unit and Hospital Settings: A Comparative Analysis. \textit{Stroke}. Dallas: Lippincott Williams \&{} Wilkins, 2018, roč.~49, č.~8, s.~1996-1999. ISSN~0039-2499. Dostupné z: https://dx.doi.org/10.1161/STROKEAHA.118.021536.
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