Evidence map›Paper›PMID 30069087›Full record

ArticleJournal of neurosciences in rural practice

Real-World Effectiveness of Intravenous Stroke Thrombolysis is more than the Expectation of Practicing Neurologists.

Fazal Ghafoor, Firosh Khan, Abdulkhader Shehna

Open access · goldAbstract read
In one paragraph

Article in Journal of neurosciences in rural practice. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 38% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. 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

3 authors at 1 institution in 1 country.

Fazal GhafoorDepartment of Neurology, MES Medical College, Perinthalmanna, India.
Firosh KhanDepartment of Neurology, MES Medical College, Perinthalmanna, India.
Abdulkhader ShehnaDepartment of Radiotherapy, Government Medical College, Thrissur, Kerala, India.
Government Medical College · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe objective of the study was to compare the actual results of intravenous thrombolytic therapy (IVTT) in acute ischemic stroke with results anticipated by neurologists in practice.

methodsNeurologists practicing in Thrissur metropolitan region, covering a population of 1.8 million, were telephonically surveyed about the number of yearly IVTT and their expert opinion/comment about effects of thrombolysis. This was compared with the results of IVTT from a single institution in the same region from 2012 to 2016.

resultsEight neurologists in the region give approximately 140-150 IVTT per year. Nearly 20%-40% (median 32%) patients have good outcome, 5%-10% (median 9%) have intracerebral hematoma (ICH), and 25%-35% (median 30%) have death/bad outcome. Two neurologists from a tertiary care hospital in the region treated 122 cases of ischemic strokes with IVTT from 2012 to 2016. Age ranged from 8 to 88 years and 88 were males. Average delay in reaching hospital was 138.1 min and the door-to-needle time was 56.3 min. There were 26 cases of posterior-circulation strokes and 14 cases of cardioembolic strokes. At presentation, average National Institute of Health Stroke Scale (NIHSS) was 14.7; Modified Rankin Scale (mRS) 0.4; and CT Alberta Stroke Program Early Computerized Tomography Scores was 9.5. Good and sustained benefit (GSB) (>4 reduction in NIHSS at 24 h and 7 days) was there in 49% and no improvement (NI)/worsening in 36%. mRS 0-2 at discharge/30 days was documented in 57.3%. Symptomatic ICH was 10% (12/122) and mortality rate was 11.5% (14/122). GSB in posterior circulation strokes was 69.2% and NI/worsening in only 7.7%. mRS was 0-2 in 77% of posterior circulation strokes.

conclusionContrary to the popular belief of the practicing neurologists, IVTT has a high percentage of good outcome with a reasonable bleeding risk and low rates of absolute futility.

Indexed as

Ischemic strokestroke outcomestroke treatment surveythrombolysis

Identifiers

PMID30069087
PMCPMC6050792
OpenAlexW2813305134

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
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.