Details:

Alternative Title:
Int J Stroke
Publisher's site:
http://dx.doi.org/10.1111/ijs.12155
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.
Subject:
[+]
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
File Type:

Supporting Files

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