Evidence map›Paper›PMID 26722667›Full record

ArticleInternational journal of neurorehabilitation

Acute Intravenous Tissue Plasminogen Activator Therapy does not Impact Community Discharge after Inpatient Rehabilitation.

Nneka L Ifejika, Farhaan Vahidy, Linda A Aramburo-Maldonado, Chunyan Cai, Melvin R Sline, James C Grotta, Sean I Savitz

Open access · greenAbstract read
PubMed Full text at PMC
In one paragraph

Article in International journal of neurorehabilitation. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Research in the Acute Rehabilitation Setting: a Bridge Too Far?Current neurology and neuroscience reports · 2019
    Review
  5. Tissue plasminogen activator; identifying major barriers related to intravenous injection in ischemic acute cerebral infraction.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2017
    Article
  6. Decrease in Insulin-Like Growth Factor-1 and Insulin-Like Growth Factor-1 Ratio in the First Week of Stroke Is Related to Positive Outcomes.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2016
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Nneka L IfejikaDepartment of Neurology (N.L.I., F.V., L.A.A., M.R.S., S.I.S,), University of Texas Health Science, Center at Houston Medical School, Houston, Texas, USA ; Department of Physical Medicine and Rehabilitation (N.L.I.), University of Texas Health Science Center at Houston Medical School, Houston, Texas, USA.
Farhaan VahidyDepartment of Neurology (N.L.I., F.V., L.A.A., M.R.S., S.I.S,), University of Texas Health Science, Center at Houston Medical School, Houston, Texas, USA.
Linda A Aramburo-MaldonadoDepartment of Physical Medicine and Rehabilitation (N.L.I.), University of Texas Health Science Center at Houston Medical School, Houston, Texas, USA.
Chunyan CaiDivision of Clinical and Translational Sciences, Department of Internal Medicine (C.C.), University of Texas Health Science Center at Houston Medical School, Houston, Texas, USA.
Melvin R SlineDepartment of Neurology (N.L.I., F.V., L.A.A., M.R.S., S.I.S,), University of Texas Health Science, Center at Houston Medical School, Houston, Texas, USA.
James C GrottaMischer Neuroscience Institute (J.C.G.), Memorial Hermann Hospital-Texas Medical Center, Houston, Texas, USA.
Sean I SavitzDepartment of Neurology (N.L.I., F.V., L.A.A., M.R.S., S.I.S,), University of Texas Health Science, Center at Houston Medical School, Houston, Texas, USA.
The University of Texas Health Science Center at Houston · US

Funding

University of Texas Specialized Program in Acute StrokeP50NS044227 · NINDS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI GROTTA, JAMES C · 2002 to 2012
$17.9M
Center for Clinical and Translational Sciences (CCTS)UL1TR000371 · NCATS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI MCPHERSON, DAVID D · 2012 to 2016
$13.4M
CTSA: K12 COMPONENTKL2RR024149 · NCRR · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI MCPHERSON, DAVID D · 2006 to 2011
$6.7M
Center for Clinical and Translational Sciences (CCTS)KL2TR000370 · NCATS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI MCPHERSON, DAVID D · 2012 to 2016
$4.3M
NCATS NIH HHS KL2 TR000370NCATS NIH HHS UL1 TR000371NCRR NIH HHS KL2 RR024149NINDS NIH HHS P50 NS044227
6 · The paper itself

Abstract

background and purposeDischarge status and acute re-hospitalization are used as indicators of stroke severity and recovery. Intravenous t-PA (tissue plasminogen activator) is one of two treatments shown to have a positive impact. Stroke rehabilitation patients are an important population who will end up integrated back into the community, institutionalized or hospitalized due to late stroke complications. We sought to determine factors contributing to post rehabilitation discharge and acute re-hospitalization, in particular, the impact of t-PA therapy.

methodsRetrospective analysis of census data from ischemic stroke patients on the UTHealth Stroke/Neurorehabilitation Services at Memorial Hermann Hospital - Texas Medical Center between Jan 2011 and Nov 2013, discharged to the Community, SNF (Skilled Nursing Facility) or AC (Acute Care). Demographics and NIHSS (National Institutes of Health Stroke Scale) were collected. Discharge FIM (Functional Independence Measure) was the reference standard. Genitourinary infections were a negative mediator in the multivariate regression.

resultsOf 346 patients, 274 returned to the community, 47 to SNF, and 25 to AC. NIHSS AND T-PA THERAPY: Median NIHSS values were 8 in the community group, 11 in SNF and 9.5 in AC. 31.8% of patients received IV t-PA in the community group, 23.4% in SNF and 24% in AC. There were no statistically differences in community discharge rates. COMMUNITY VS AC: One day increase in rehabilitation hospitalization correlated with 19% decreased odds of AC readmission (OR 0.81; P=0.001). One unit discharge FIM increase correlated with 13% decreased odds of AC readmission (OR 0.87; P=0.003). COMMUNITY VS SNF: One year age increase correlated with 4% increased odds of SNF admission (OR 1.04; P=0.02).

conclusionsIntense rehabilitation evidenced by FIM improvement and length of stay, impacts community discharge in mild to moderate stroke patients. t-PA had no effect. This study is limited by sample size, retrospective design and undetermined psychosocial factors.

Indexed as

Acute thrombolysisFunctional independence measureHospital re-admissionOutcomesSkilled nursing facilityStroke rehabilitation

Identifiers

PMID26722667
PMCPMC4694634
OpenAlexW2414110520

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.