J 2018

Ultraearly Intravenous Thrombolysis for Acute Ischemic Stroke in Mobile Stroke Unit and Hospital Settings: A Comparative Analysis

TSIVGOULIS, Georgios, Frederik GEISLER, Aristeidis H. KATSANOS, Janika KORV, Alexander KUNZ et. al.

Basic information

Original name

Ultraearly Intravenous Thrombolysis for Acute Ischemic Stroke in Mobile Stroke Unit and Hospital Settings: A Comparative Analysis

Authors

TSIVGOULIS, Georgios (300 Greece), Frederik GEISLER (276 Germany), Aristeidis H. KATSANOS (300 Greece), Janika KORV (233 Estonia), Alexander KUNZ (276 Germany), Robert MIKULÍK (203 Czech Republic, belonging to the institution), Michal ROZANSKI (276 Germany), Matthias WENDT (276 Germany) and Heinrich J. AUDEBERT (276 Germany, guarantor)

Edition

Stroke, Dallas, Lippincott Williams & Wilkins, 2018, 0039-2499

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 6.058

RIV identification code

RIV/00216224:14110/18:00104180

Organization unit

Faculty of Medicine

DOI

UT WoS

000439576500042

Keywords in English

intracranial hemorrhages; reperfusion; stroke; acute; thrombolytic therapy

Tags

Tags

International impact, Reviewed
Změněno: 11/2/2019 15:47, Soňa Böhmová

Abstract

V originále

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.