ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2019
Management of acute ischemic stroke, thrombolysis rate, and predictors of clinical outcome.
Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Baseline neurological deficit and argatroban plus alteplase in acute ischemic stroke: A post hoc analysis of ARAIS trial.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2024Trial
- Effect of soluble dietary fiber extracted fromFrontiers in nutrition · 2025Article
- Predictors of spontaneous intracerebral hemorrhage mortality: a community-based study in Brno, Czech Republic.Acta neurologica Belgica · 2024Article
- Functioning and recovery during stroke rehabilitation: a comparison between pre-stroke frail and non-frail patients.European geriatric medicine · 2023Article
- Effect of Intravenous Thrombolytic Dose of Alteplase on Long-Term Prognosis in Patients with Acute Ischemic Stroke.Neurology and therapy · 2023Article
- NIHSS-the Alberta Stroke Program Early CT Score mismatch in guiding thrombolysis in patients with acute ischemic stroke.Journal of neurology · 2022Observational
- Quality of acute ischemic stroke care at a tertiary Hospital in Ghana.BMC neurology · 2022Article
- Cost-effectiveness of artificial intelligence aided vessel occlusion detection in acute stroke: an early health technology assessment.Insights into imaging · 2021Article
- Prognostic Factors in Neurorehabilitation of Stroke: A Comparison among Regression, Neural Network, and Cluster Analyses.Brain sciences · 2021Article
- Implementation of a provincial acute stroke pathway and its impact on access to advanced stroke care in Saskatchewan.BMJ open quality · 2021Article
- Fasting Normoglycemia after Intravenous Thrombolysis Predicts Favorable Long-Term Outcome in Non-Diabetic Patients with Acute Ischemic Stroke.Journal of clinical medicine · 2021Article
- The application of the emergency green channel integrated management strategy in intravenous thrombolytic therapy for AIS.American journal of translational research · 2021Article
- Do We Need to Distinguish Thrombolysis and Nonthrombolysis Patients When Applying Stroke-Associated Pneumonia Predicting Scores? An External Validation from a 2-Center Database.Medical science monitor : international medical journal of experimental and clinical research · 2020Observational
- Article
- The global burden of cerebral small vessel disease related to neurological deficit severity and clinical outcomes of acute ischemic stroke after IV rt-PA treatment.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2019Article
- Health outcomes after acute ischemic stroke:retrospective and survival analysis from Oman.Annals of Saudi medicineArticle
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10 authors.
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Abstract
BACKGROUND AND
aimsMonitoring the quality of acute ischemic stroke (AIS) management is increasingly important since patient outcome could be improved with better access to evidence-based treatments. In this scenario, the aim of our study was to identify thrombolysis rate, reasons for undertreatment, and factors associated with better outcome.
methodsFrom January to December 2016, individuals diagnosed with AIS at the Policlinic San Martino Hospital in Genoa, Italy, were prospectively included. Severity of stroke, site of occlusion, rate and time related in-hospital management of systemic thrombolysis, and mechanical thrombectomy were recorded. Safety and clinical outcomes were compared between different subgroups.
resultsOf 459 AIS patients (57.3% females, mean age 78.1), 111 received i.v. thrombolysis (24.4%) and 50 received mechanical thrombectomy (10.9%). Apart from arrival behind the therapeutic window, which was the first limitation to thrombolysis, the main reason of undertreatment was minor stroke or stroke in rapid improvement. Baseline NIHSS ≥ 8 was associated with unfavorable clinical outcome (mRS > 2) (OR 20.1; 95% CI, 1.1-387.4, p = 0.047). Age older than 80 years (OR 5.0; 95% CI, 1.4-64.1, p = 0.01), baseline NIHSS ≥ 7 (OR 20.1; 95% CI, 1.1-387.4, p = 0.047), and symptomatic intracranial hemorrhage (OR 22.9; 95% CI, 2.0-254.2, p = 0.01) proved independently associated with mortality.
conclusionsi.v. thrombolysis and mechanical thrombectomy rate was higher than that of previous reports. Minor stroke or stroke in rapid improvement was a major reason for exclusion from thrombolysis of eligible patients. Higher NIHSS proved an independent predictor of unfavorable clinical outcome and death. Strategies to avoid in-hospital delays need to be enforced.
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