Details:

Alternative Title:
Int J Stroke
Personal Author:
Tong, Xin ; George, Mary G. ; Yang, Quanhe ; Gillespie, Cathleen
Tong, Xin ; George, Mary G. ; Yang, Quanhe ; Gillespie, Cathleen Less -
Description:
Background

Limited studies exist on the outcome of thrombolytic therapy of acute ischemic stroke patients outside of clinical trials.

Aim

To assess the possible risk factors associated with in-hospital death and symptomatic intracerebral hemorrhage among patients who received intravenous tissue plasminogen activator.

Methods

A total of 7193 patients with a clinical diagnosis of acute ischemic stroke and a documented National Institutes of Health Stroke Scale score were treated with intravenous tissue plasminogen activator within 4·5 hours of time last known to be well. Generalized estimating equations modeling was used to assess the associations of in-hospital death and symptomatic intracerebral hemorrhage with clinical characteristics.

Results

Among 7193 patients treated with intravenous tissue plasminogen activator, 516 (7·2%) died during hospitalization. Factors associated with in-hospital death were older age, male gender, National Institutes of Health Stroke Scale score, history of myocardial infarction or coronary artery disease, and history of nonvalvular atrial fibrillation. Increasing age, higher National Institutes of Health Stroke Scale score, and history of dyslipidemia were associated with symptomatic intracerebral hemorrhage. There was no difference in the rates of in-hospital death or symptomatic intracerebral hemorrhage among patients treated with intravenous tissue plasminogen activator within three-hours of time last known to be well and those treated between three and 4·5 hours after this time.

Conclusions

In this study of acute ischemic stroke patients, older age, male gender, National Institutes of Health Stroke Scale score, history of myocardial infarction or coronary artery disease, and history of atrial fibrillation were associated with increased in-hospital death among patients receiving intravenous tissue plasminogen activator. Among patients treated with intravenous tissue plasminogen activator, in-hospital mortality and symptomatic intracerebral hemorrhage rates were similar between those treated within three-hours of time last known to be well and those treated between three and 4·5 hours after this time.


Subjects:
[+]
Acute Stroke Adolescent Adult Aged Aged, 80 And Over Article Brain Ischemia Dyslipidemias Female Fibrinolytic Agents Hospital Mortality Humans Intracranial Hemorrhages Male Middle Aged Myocardial Ischemia Prognosis Registries Risk Factors Severity Of Illness Index Stroke Stroke Outcomes Symptomatic Intracerebral Hemorrhage Thrombolysis Thrombolytic Therapy Tissue Plasminogen Activator Young Adult
Source:
Int J Stroke. 2013; 9(6):728-734.
Pubmed ID:
24024962
Pubmed Central ID:
PMC4451118
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:9324ee48a96574312421d526053875a9b520e868f9286c0efc996eea46015212
Download URL:
https://stacks.cdc.gov/view/cdc/31394/cdc_31394_DS1.pdf
File Type:

Supporting Files

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