Evidence map›Paper›PMID 34753432›Full record

Observational studyBMC neurology2021

Outcomes of stroke patients undergoing thrombolysis in Sri Lanka; an observational prospective study from a low-middle income country.

H M M T B Herath, Chaturaka Rodrigo, A M B D Alahakoon, Sathyajith Buddhika Ambawatte, Sunethra Senanayake, Bimsara Senanayake, Arjuna Fernando

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 21% 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Global stroke statistics 2023: Availability of reperfusion services around the world.International journal of stroke : official journal of the International Stroke Society · 2024
    Review
  5. Article
  6. Article
  7. Determinants of 1-Year Unfavorable Outcomes of Intravenous Alteplase Thrombolysis for Acute Ischemic Stroke.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Observational
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 2 institutions in 2 countries.

H M M T B HerathNeurology Department, National Hospital of Sri Lanka, Colombo, Sri Lanka. Tharukaherath11@gmail.com.
Chaturaka RodrigoDepartment of Pathology, School of Medical Sciences, UNSW Sydney, Sydney, NSW, Australia.
A M B D AlahakoonNeurology Department, National Hospital of Sri Lanka, Colombo, Sri Lanka.
Sathyajith Buddhika AmbawatteNeurology Department, National Hospital of Sri Lanka, Colombo, Sri Lanka.
Sunethra SenanayakeNeurology Department, National Hospital of Sri Lanka, Colombo, Sri Lanka.
Bimsara SenanayakeNeurology Department, National Hospital of Sri Lanka, Colombo, Sri Lanka.
Arjuna FernandoNeurology Department, National Hospital of Sri Lanka, Colombo, Sri Lanka.
National Hospital of Sri Lanka · LKUNSW Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStroke related deaths are relatively higher in low- and middle-income countries where only a fraction of eligible patients undergo thrombolysis. There is also limited evidence on post-thrombolysis outcomes of patients from Asian countries in these income bands.

methodsThis is a single center prospective observational study of a patient cohort with acute ischaemic stroke, undergoing thrombolysis with alteplase (low and standard dose), over a 24-month period in 2019/2020. Modified Rankin scale (mRS) for dependency at 3 months (primary outcome), duration of hospital stay, incidence of symptomatic intracranial haemorrhages and all-cause mortality at 3 months (secondary outcomes) were recorded. Demographic, clinical and treatment related factors associated with these outcomes were explored.

resultsEighty-nine patients (males - 61, 69%, mean age: 60 years ±12.18) were recruited. Time from symptom onset to reperfusion was 174 min ± 56.50. Fifty-one patients were independent according to mRS, 11 (12.4%) patients died, and 11 (12.5%) developed symptomatic intracranial haemorrhages by 3 months. Functional independence at 3 months was independently associated with National Institutes of Health Stroke Scale (NIHSS) on admission (p < 0.05). Thrombolysis with low dose alteplase did not lead to better or worse outcomes compared to standard dose.

conclusionsOn admission NIHSS is predictive of functional independence at 3 months post-thrombolysis. Low dose alteplase may be as efficacious as standard dose alteplase with associated cost savings, but this needs to be confirmed by a prospective clinical trial for the Sri Lankan population.

Indexed as

Brain IschemiaStrokeAgedFemaleFibrinolytic AgentsHumansMaleMiddle AgedProspective StudiesSri LankaThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeFibrinolytic AgentsTissue Plasminogen ActivatorObservational prospective studySri LankaStrokeThrombolysis

Identifiers

PMID34753432
PMCPMC8576930
OpenAlexW3187998764

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.