Temporal Trends in Intravenous Thrombolysis in Acute Ischemic Stroke: Experience from a Tertiary Care Center in India

Khurana, Dheeraj; Das, Biplab; Kumar, Ashok; Kumar, Susheel; Khandelwal, Niranjan; Lal, Vivek; Prabhakar, Sudesh

doi:10.1016/j.jstrokecerebrovasdis.2017.01.019

Cited by 16 publications

(19 citation statements)

References 18 publications

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“…[ 16 ] This pattern of using private vehicles is also seen in another study from the North India where 201 patients used ambulance services but 578 used private or public vehicles. [ 9 ] Mean O-D time in the current study was longer than the previous report from our center[ 11 ] but less than that of other reports from India. [ 13 19 ]…”

Section: Discussioncontrasting

confidence: 74%

“…D-CT time in the current study was longer than three studies reported from India. [ 9 13 19 ] These were 17 (10–30) min, 31 ± 25.6 min, and 24 (10–47) min, respectively. The delay most commonly occurs when relatives are reluctant to make a decision about admitting and imaging the patient.…”

Section: Discussionmentioning

confidence: 98%

“…[ 23 ] Similar reasons for not thrombolysing eligible patients were observed in other studies from India. [ 9 11 13 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 6 7 ] Data on hyperacute stroke care, time taken for imaging, and treatment are limited from Indian subcontinent. [ 8 9 ] Thus, this study was designed to assess the quality of hyperacute stroke care using thrombolysis rate, onset-to-door (O-D), door-to-examination (D-E), door-to-imaging (D-CT), and door-to-needle (D-N) time in our SU.…”

Section: Introductionmentioning

confidence: 99%

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Quality indicators of intravenous thrombolysis from North India

William¹,

Pannu²,

Kate³

et al. 2017

Ann Indian Acad Neurol

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Background:Data on intravenous (IV) thrombolysis using tissue plasminogen activator (tPA) are limited from low- and middle-income countries. We aimed to assess the quality indicators of IV thrombolysis in our stroke unit.Methods:All stroke patients admitted in our hospital from October 2008 to April 2017 were included in this study. Data were collected prospectively by trained research staff in a detailed case record form. Outcome was assessed using modified Rankin Scale (mRS, 0–1 good outcome).Results:Of the total 4720 stroke patients seen, 944 (20%) came within window period (<4.5 h). Of these, 214 (4.5%) were eligible for thrombolysis and 170 (3.6%) were thrombolysed, relatives of 23 (23/214, 10.7%) patients denied consent, and 21 (9.8%) patients could not afford tPA. The mean age of thrombolysed patients was 58.4 (range 19–95) years. Median NIHSS at admission was 12 (interquartile range 2–24). Average onset-to-door (O-D) time was 76.8 (5–219) min, door-to-examination (D-E) time was 17.8 (5–105) min, door-to-CT (D-CT) time was 48 (1–205) min, and door-to-needle (D-N) time was 90 (20–285) min. At 6 months, 110 (64.7%) patients were contactable and 82 (74.5%) patients had good outcome (mRS 0–1).Conclusion:Thrombolysis rate has steadily increased at the center without undue adverse effects even in the elderly. D-E and D-CT times have reduced, but O-D and D-N times need further improvement. More patients could be thrombolysed if the cost of tPA is reduced and the consent process is waived.

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Section: Discussioncontrasting

confidence: 74%

Section: Discussionmentioning

confidence: 98%

“…[ 23 ] Similar reasons for not thrombolysing eligible patients were observed in other studies from India. [ 9 11 13 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Quality indicators of intravenous thrombolysis from North India

William¹,

Pannu²,

Kate³

et al. 2017

Ann Indian Acad Neurol

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show abstract

“…excellent outcome), corresponding to other published data in Asia (26.1%-59.0%). (17)(18)(19)(20)(21)(22)(23)(24)(25)(26) In the studies conducted in Europe and Canada, a three-month mRS score of 0-1 was observed in 31%-53% of the patients. (27)(28)(29)(30) SICH occurred in 5.6% of the patients, which was also similar to the previous literature.…”

Section: Discussionmentioning

confidence: 99%

Predictors of functional outcome in patients with stroke thrombolysis in a tertiary hospital in Malaysia

Mls¹,

Kj²,

Kaa³

et al. 2019

smedj

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We recruited patients who were admitted to UMMC, Kuala Lumpur, Malaysia, for AIS between February 2012 and August 2016. The data of consecutive patients from the stroke thrombolysis registry was recorded. The inclusion and exclusion criteria for stroke thrombolysis were based on the National Institute of Neurological Disorders and Stroke trial in the United States. (10) The baseline demographic and clinical data of patients, including age, gender, ethnicity, vascular risk factors, stroke subtypes, blood pressure on admission, National Institutes of Health Stroke Scale (NIHSS)

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Cathepsin K Knockout Exacerbates Haemorrhagic Transformation Induced by Recombinant Tissue Plasminogen Activator After Focal Cerebral Ischaemia in Mice

Zhao

Shi

et al. 2019

Cell Mol Neurobiol

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Temporal Trends in Intravenous Thrombolysis in Acute Ischemic Stroke: Experience from a Tertiary Care Center in India

Cited by 16 publications

References 18 publications

Quality indicators of intravenous thrombolysis from North India

Quality indicators of intravenous thrombolysis from North India

Predictors of functional outcome in patients with stroke thrombolysis in a tertiary hospital in Malaysia

Cathepsin K Knockout Exacerbates Haemorrhagic Transformation Induced by Recombinant Tissue Plasminogen Activator After Focal Cerebral Ischaemia in Mice

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