Evidence map›Paper›PMID 32206899›Full record

SynthesisJournal of neurology2021

Factors delaying intravenous thrombolytic therapy in acute ischaemic stroke: a systematic review of the literature.

Angelos Sharobeam, Brett Jones, Dianne Walton-Sonda, Christian J Lueck

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 4 pooled it
–field-weighted citation impact
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

28 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
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  14. Targeted Metabolomic Biomarkers for Stroke Subtyping.Translational stroke research · 2024
    Article
  15. Article
  16. Article
  17. Article
  18. If Time is Neuron, What Are We Waiting for?Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023
    Article
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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

4 authors.

Angelos SharobeamDepartment of Neurology, The Canberra Hospital, Canberra, Australia. Angelos.Sharobeam@act.gov.au.ORCID http://orcid.org/0000-0001-5833-7632
Brett JonesDepartment of Neurology, The Canberra Hospital, Canberra, Australia.ORCID http://orcid.org/0000-0002-1459-9718
Dianne Walton-SondaAustralian National University Medical School, Canberra, Australia.
Christian J LueckDepartment of Neurology, The Canberra Hospital, Canberra, Australia.ORCID http://orcid.org/0000-0003-1537-7612

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

aimsThis review examined factors that delay thrombolysis and what management strategies are currently employed to minimise this delay, with the aim of suggesting future directions to overcome bottlenecks in treatment delivery.

methodsA systematic review was performed according to PRISMA guidelines. The search strategy included a combination of synonyms and controlled vocabularies from Medical Subject Headings (MeSH) and EmTree covering brain ischemia, cerebrovascular accident, fibrinolytic therapy and Alteplase. The search was conducted using Medline (OVID), Embase (OVID), PubMed and Cochrane Library databases using truncations and Boolean operators. The literature search excluded review articles, trial protocols, opinion pieces and case reports. Inclusion criteria were: (1) The article directly related to thrombolysis in ischaemic stroke, and (2) The article examined at least one factor contributing to delay in thrombolytic therapy.

resultsOne hundred and fifty-two studies were included. Pre-hospital factors resulted in the greatest delay to thrombolysis administration. In-hospital factors relating to assessment, imaging and thrombolysis administration also contributed. Long onset-to-needle times were more common in those with atypical, or less severe, symptoms, the elderly, patients from lower socioeconomic backgrounds, and those living alone. Various strategies currently exist to reduce delays. Processes which have achieved the greatest improvements in time to thrombolysis are those which integrate out-of-hospital and in-hospital processes, such as the Helsinki model.

conclusionFurther integrated processes are required to maximise patient benefit from thrombolysis. Expansion of community education to incorporate less common symptoms and provision of alert pagers for patients may provide further reduction in thrombolysis times.

Indexed as

Brain IschemiaIschemic StrokeStrokeAgedFibrinolytic AgentsHumansThrombolytic TherapyTissue Plasminogen ActivatorFibrinolytic AgentsTissue Plasminogen ActivatorDelayReviewStrokeThrombolysis

Identifiers

PMID32206899

What OpenQuestion holds

Textmetadata
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.