Contemporary Trends in the Treatment of Mild Ischemic Stroke with Intravenous Thrombolysis : Paul Coverdell National Acute Stroke Program
© 2021 S. Karger AG, Basel..
BACKGROUND: Presentation with mild symptoms is a common reason for intravenous thrombolysis (IVT) nonuse among acute ischemic stroke (AIS) patients. We examined the impact of IVT on the outcomes of mild AIS over time.
METHODS: Using the Paul Coverdell National Stroke Program data, we examined trends in IVT utilization from 2010 to 2019 among AIS patients presenting with National Institutes of Health Stroke Scale (NIHSS) scores ≤5. Outcomes adjudicated included rates of discharge to home and ability to ambulate independently at discharge. We used generalized estimating equation models to examine the effect of IVT on outcomes of AIS patients presenting with mild symptoms and calculated adjusted odds ratio (AOR) with 95% confidence intervals (CI).
RESULTS: During the study period, 346,762 patients presented with mild AIS symptoms. Approximately 6.2% were treated with IVT. IVT utilization trends increased from 3.7% in 2010 to 7.7% in 2019 (p < 0.001). Patients treated with IVT had higher median NIHSS scores upon presentation (IVT 3 [2, 4] vs. no IVT 2 [0, 3]). Rates of discharge to home (AOR 2.06, 95% CI: 1.99-2.13) and ability to ambulate at time of discharge (AOR 1.82, 95% CI: 1.76-1.89) were higher among those treated with IVT.
CONCLUSION: There was an increased trend in IVT utilization among AIS patients presenting with mild symptoms. Utilization of IVT increased the odds of being discharged to home and the ability to ambulate at discharge independently in patients with mild stroke.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:51 |
|---|---|
| Enthalten in: |
Cerebrovascular diseases (Basel, Switzerland) - 51(2022), 1 vom: 30., Seite 60-66 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Asaithambi, Ganesh [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Fibrinolytic Agents |
|---|
| Anmerkungen: |
Date Completed 20.04.2022 Date Revised 20.04.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1159/000517969 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM33057258X |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM33057258X | ||
| 003 | DE-627 | ||
| 005 | 20231225211555.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1159/000517969 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1101.xml |
| 035 | |a (DE-627)NLM33057258X | ||
| 035 | |a (NLM)34515074 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Asaithambi, Ganesh |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Contemporary Trends in the Treatment of Mild Ischemic Stroke with Intravenous Thrombolysis |b Paul Coverdell National Acute Stroke Program |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 20.04.2022 | ||
| 500 | |a Date Revised 20.04.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021 S. Karger AG, Basel. | ||
| 520 | |a BACKGROUND: Presentation with mild symptoms is a common reason for intravenous thrombolysis (IVT) nonuse among acute ischemic stroke (AIS) patients. We examined the impact of IVT on the outcomes of mild AIS over time | ||
| 520 | |a METHODS: Using the Paul Coverdell National Stroke Program data, we examined trends in IVT utilization from 2010 to 2019 among AIS patients presenting with National Institutes of Health Stroke Scale (NIHSS) scores ≤5. Outcomes adjudicated included rates of discharge to home and ability to ambulate independently at discharge. We used generalized estimating equation models to examine the effect of IVT on outcomes of AIS patients presenting with mild symptoms and calculated adjusted odds ratio (AOR) with 95% confidence intervals (CI) | ||
| 520 | |a RESULTS: During the study period, 346,762 patients presented with mild AIS symptoms. Approximately 6.2% were treated with IVT. IVT utilization trends increased from 3.7% in 2010 to 7.7% in 2019 (p < 0.001). Patients treated with IVT had higher median NIHSS scores upon presentation (IVT 3 [2, 4] vs. no IVT 2 [0, 3]). Rates of discharge to home (AOR 2.06, 95% CI: 1.99-2.13) and ability to ambulate at time of discharge (AOR 1.82, 95% CI: 1.76-1.89) were higher among those treated with IVT | ||
| 520 | |a CONCLUSION: There was an increased trend in IVT utilization among AIS patients presenting with mild symptoms. Utilization of IVT increased the odds of being discharged to home and the ability to ambulate at discharge independently in patients with mild stroke | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Mild stroke | |
| 650 | 4 | |a Outcomes | |
| 650 | 4 | |a Stroke | |
| 650 | 4 | |a Thrombolysis | |
| 650 | 7 | |a Fibrinolytic Agents |2 NLM | |
| 700 | 1 | |a Tong, Xin |e verfasserin |4 aut | |
| 700 | 1 | |a Coleman King, Sallyann M |e verfasserin |4 aut | |
| 700 | 1 | |a George, Mary G |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Cerebrovascular diseases (Basel, Switzerland) |d 1997 |g 51(2022), 1 vom: 30., Seite 60-66 |w (DE-627)NLM090577663 |x 1421-9786 |7 nnns |
| 773 | 1 | 8 | |g volume:51 |g year:2022 |g number:1 |g day:30 |g pages:60-66 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1159/000517969 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 51 |j 2022 |e 1 |b 30 |h 60-66 | ||