Background
Only 2%-3% of patients with acute ischemic stroke receive thrombolysis. The aim of
this study was to identify the reasons for exclusion from thrombolysis in patients
admitted within the therapeutic time window.
Methods
Patient data in the hospital stroke registry between January 2012 and September 2013
were retrospectively examined. All cases with a diagnosis of ischemic stroke were
screened, and those admitted to the neurology wards within 4.5 hours of symptom onset
were analyzed. The reasons for exclusion from thrombolysis were examined. Logistic
regression analysis was used to find independent predictors of thrombolysis treatment.
Results
Of the 1579 cases of ischemic stroke, 234 patients were admitted to the neurology
ward within 4.5 hours of symptom onset. A total of 57 patients received thrombolysis.
The thrombolysis rate was 3.6% of all ischemic stroke patients. Of the 177 patients
who were excluded from thrombolysis, 36.2% (n = 64) had stroke of insufficient severity
to warrant thrombolysis, and 24.9% (n = 44) were older than 80 years. Logistic regression
analysis showed that the interval between symptom onset and admission (odds ratio
20.24, 95% confidence interval 3.75-109.24) and history of ischemic stroke (odds ratio
.11, 95% confidence interval .04-.34) affected the likelihood of thrombolysis.
Conclusions
Mild stroke and advanced age were the major reasons for exclusion from thrombolysis
in patients admitted within 4.5 hours of symptom onset. Patients who were admitted
early and those without a history of ischemic stroke were more likely to receive thrombolysis.
Key Words
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Article info
Publication history
Published online: March 03, 2014
Accepted:
December 25,
2013
Received in revised form:
December 23,
2013
Received:
December 13,
2013
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.12.041
Copyright
© 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.
