Stroke thrombolysis: having more time translates into delayed therapy: data from the Austrian Stroke Unit Registry.

Abstract:

BACKGROUND AND PURPOSE:Efficacy of intravenous thrombolysis in acute ischemic stroke declines with increasing time to treatment initiation. Previous small-scale studies suggested that the earlier patients arrive, the longer it takes to administer recombinant tissue plasminogen activator. METHODS:Of 32 529 patients with stroke prospectively enrolled in the Austrian Stroke Unit Registry (2004 to 2009), 3287 received intravenous thrombolysis and 2663 of them were eligible for the current analysis. RESULTS:Median (interquartile range) onset-to-door and door-to-needle times were 70 (50 to 100) and 50 (35 to 70) minutes. Of note, both time intervals were inversely correlated with each other. After adjustment for multiple stroke characteristics, the door-to-needle time of patients arriving in the hospital within the first hour after stroke onset was 6.9 minutes (P<0.001) and 13.9 minutes (P<0.001) longer than those for patients arriving between 61 to 120 and 121 to 180 minutes. Findings were consistent in subgroups. CONCLUSIONS:Early hospital arrival translates into a significant delay in the application of intravenous thrombolysis among patients with acute stroke. This finding calls for concerted measures to ensure that all patients with stroke are treated with the same urgency irrespective of the time available.

journal_name

Stroke

journal_title

Stroke

authors

Ferrari J,Knoflach M,Kiechl S,Willeit J,Matosevic B,Seyfang L,Lang W,Austrian Stroke Unit Registry Collaborators.

doi

10.1161/STROKEAHA.110.590372

subject

Has Abstract

pub_date

2010-09-01 00:00:00

pages

2001-4

issue

9

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.110.590372

journal_volume

41

pub_type

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