Abstract:
BACKGROUND AND PURPOSE:We used Riks-Stroke, the Swedish Stroke Register, to explore how thrombolysis has been disseminated in Swedish hospitals since it was approved in 2003. METHODS:All 78 hospitals in Sweden admitting patients with acute stroke participate in Riks-Stroke. Between 2003 and 2008, 72 033 adult patients were hospitalized for acute ischemic stroke. We analyzed thrombolysis use by region, patient characteristics, and stroke service settings. RESULTS:Nationwide, the use of thrombolysis increased from 0.9% in 2003 to 6.6% in 2008. There were marked regional differences in the dissemination of thrombolysis, but these gaps narrowed over time. Nonuniversity hospitals reached treatment levels similar to university settings, although with a 2- to 3-year delay. Symptomatic intracranial hemorrhage remained at the 3% to 9% level without an apparent time trend during dissemination. Independent predictors of higher thrombolysis use included younger age, male sex, not living alone, and no history of stroke or diabetes. In 2008, patients admitted to a stroke unit were 5 times more likely to receive thrombolysis than those admitted to general wards. CONCLUSIONS:Nationwide implementation of thrombolysis has been slow but has accelerated mainly due to increased access outside university hospitals. The increased use has been achieved safely, but access has been unequal.
journal_name
Strokejournal_title
Strokeauthors
Eriksson M,Jonsson F,Appelros P,Asberg KH,Norrving B,Stegmayr B,Terént A,Asplund K,Riks-Stroke Collaboration.doi
10.1161/STROKEAHA.109.577106subject
Has Abstractpub_date
2010-06-01 00:00:00pages
1115-22issue
6eissn
0039-2499issn
1524-4628pii
STROKEAHA.109.577106journal_volume
41pub_type
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