Systemic thrombolytic therapy in acute ischemic stroke — New experiences in spreading network of stroke units in Croatia
Autor: | Branko Radanović, Mario Habek, Antonija Mišmaš, Branko Malojčić, Spomenka Kiđemet-Piskač, Vesna Matijević, Marina Boban, Klaudia Duka Glavor, Antonela Bazina, Ivica Bilić, Zdravka Poljaković |
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Rok vydání: | 2012 |
Předmět: |
Male
Emergency Medical Services medicine.medical_specialty Croatia medicine.medical_treatment Diastole Blood Pressure Brain Ischemia medicine Humans Thrombolytic Therapy Stroke Acute ischemic stroke Aged Cerebral Hemorrhage Retrospective Studies Aged 80 and over Nihss score business.industry Public health Stroke units Thrombolysis Middle Aged medicine.disease Door to needle time Treatment Outcome Neurology Data Interpretation Statistical Tissue Plasminogen Activator Emergency medicine Physical therapy stroke thrombolysis rt-PA Female Neurology (clinical) Tomography X-Ray Computed business Hospital Units |
Zdroj: | Journal of the Neurological Sciences. 314:126-129 |
ISSN: | 0022-510X |
Popis: | Background The aims of this paper are: 1) to present the data of systemic thrombolysis for ischemic stroke in five Croatian centers from July 2008 till January 2010; 2) to compare the results between centers and; 3) to compare data with previously published results from 2006 to 2008 period from our center, and with the data from SITS (Safe Implementation of Treatments in Stroke). Methods We retrospectively reviewed the medical data of thrombolysed patients in following hospitals: University Hospital Center Zagreb (91 patients), University Hospital Split (25 patients), University Hospital Osijek (22 patients), General Hospital Varaždin (21 patient), and General Hospital Zadar (7 patients). Results The “time to door” for all centers was 79.71 ± 38.63 min, the “door to needle” period was 64.39 ± 24.18 min. Systolic and diastolic blood pressures at admission were 158.65 ± 27.72 and 90.18 ± 15.03 mm Hg, respectively. Systolic and diastolic blood pressures measured immediately prior to administering rt-PA were 152.19 ± 23.17 and 85.40 ± 15.27 mm Hg, respectively. Initial median NIHSS score was 12, median NIHSS 2 h post thrombolysis was 8, and 7th day after rt-PA treatment 4. Intracerebral hemorrhages or secondary hemorrhagic transformations occurred in 21 (12.65%) patients, among which nine were symptomatic. In a 4.5 h time window total of 17 patients were thrombolysed. We did not find any differences in outcome between this group and group of patients thrombolysed in the 3 h time-window. The group of patients older than 80 years had a worse outcome. Conclusions According to our data, treatment with rt-PA is safe, feasible and effective for stroke patients in both university as well as regional hospitals having stroke units established. Organization of stroke units in regional hospitals, as well as systematic education of public health workers and neurologists, leads to the possibility for each patient to reach the nearest stroke unit and gets the thrombolytic therapy in the therapeutic time window. |
Databáze: | OpenAIRE |
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