BACKGROUND: Since doubts were raised, if a challenging medical procedure such as acute stroke treatment including thrombolysis with recombinant tissue plasminogen activator (rTPA) is available with identical standard and outcome 24 h and 7 days a week our aim was to examine if acute stroke patients defined by onset-admission time (OAT) of <or= 3 h were treated differently or had distinct outcome when admitted during off duty hours (day versus night and weekend versus weekdays) and if any differences in treatment or outcome were apparent when comparing patients admitted in the year 2003 with patients admitted in the year 2006. METHODS: We analyzed 2003-2006 data of a prospective registry and grouped patients by time, day, and year of admission. The evaluation was limited to patients that were diagnosed with ischaemic stroke and with OAT of <or= 3 h. Medical and sociodemographic items, use of thrombolytic treatment, complications during clinical course and place of discharge were obtained. Clinical state on admission and discharge was assessed using the modified Rankin scale. Comparison with chi-square test, t-test and logistic regression was performed. RESULTS: Patient's characteristics, rate of thrombolysis, and outcome were independent from time or day of admission. Proportion of patients with good clinical state at discharge increased significantly from 2003 to 2006 together with a higher rate of rTPA treatment without increase of intracranial hemorrhage. Proportion of patients discharged in good clinical condition after rTPA treatment increased from 34% to 44%. CONCLUSIONS: Stroke treatment in potential candidates for thrombolytic therapy revealed no impairment on weekend or at night already in 2003. During 4 years, it was possible to increase rate of rTPA treatment from 8.9% to 21.8% without increment of complications or death, confirming that rTPA is safe and can be implemented with full daily and weekly coverage.
BACKGROUND: Since doubts were raised, if a challenging medical procedure such as acute stroke treatment including thrombolysis with recombinant tissue plasminogen activator (rTPA) is available with identical standard and outcome 24 h and 7 days a week our aim was to examine if acute strokepatients defined by onset-admission time (OAT) of <or= 3 h were treated differently or had distinct outcome when admitted during off duty hours (day versus night and weekend versus weekdays) and if any differences in treatment or outcome were apparent when comparing patients admitted in the year 2003 with patients admitted in the year 2006. METHODS: We analyzed 2003-2006 data of a prospective registry and grouped patients by time, day, and year of admission. The evaluation was limited to patients that were diagnosed with ischaemic stroke and with OAT of <or= 3 h. Medical and sociodemographic items, use of thrombolytic treatment, complications during clinical course and place of discharge were obtained. Clinical state on admission and discharge was assessed using the modified Rankin scale. Comparison with chi-square test, t-test and logistic regression was performed. RESULTS:Patient's characteristics, rate of thrombolysis, and outcome were independent from time or day of admission. Proportion of patients with good clinical state at discharge increased significantly from 2003 to 2006 together with a higher rate of rTPA treatment without increase of intracranial hemorrhage. Proportion of patients discharged in good clinical condition after rTPA treatment increased from 34% to 44%. CONCLUSIONS:Stroke treatment in potential candidates for thrombolytic therapy revealed no impairment on weekend or at night already in 2003. During 4 years, it was possible to increase rate of rTPA treatment from 8.9% to 21.8% without increment of complications or death, confirming that rTPA is safe and can be implemented with full daily and weekly coverage.
Authors: Ingrid V Rodríguez-Rivera; Fernando Santiago; Estela S Estapé; Lorena González-Sepúlveda; Ricardo Brau Journal: P R Health Sci J Date: 2015-09 Impact factor: 0.705
Authors: Valerian L Altersberger; Patrick R Wright; Sabine A Schaedelin; Gian Marco De Marchis; Henrik Gensicke; Stefan T Engelter; Marios Psychogios; Timo Kahles; Martina Goeldlin; Thomas R Meinel; Pasquale Mordasini; Johannes Kaesmacher; Alexander von Hessling; Jochen Vehoff; Johannes Weber; Susanne Wegener; Stephan Salmen; Rolf Sturzenegger; Friedrich Medlin; Christian Berger; Ludwig Schelosky; Susanne Renaud; Julien Niederhauser; Christophe Bonvin; Michael Schaerer; Marie-Luise Mono; Biljana Rodic; Guido Schwegler; Nils Peters; Manuel Bolognese; Andreas R Luft; Carlo W Cereda; Georg Kägi; Patrick Michel; Emmanuel Carrera; Marcel Arnold; Urs Fischer; Krassen Nedeltchev; Leo H Bonati Journal: Eur Stroke J Date: 2022-04-27
Authors: Joyce T Johnson; Lynn A Sleeper; Shan Chen; Richard G Ohye; Michael G Gaies; Ismee A Williams; Ritu Sachdeva; Jay D Pruetz; Gregory H Tatum; Deepika Thacker; Marissa A Brunetti; Michele A Frommelt; Jeffrey P Jacobs; Joel A Kirsh; Linda M Lambert; Jane W Newburger; Victoria L Pemberton; Sinai C Zyblewski; Allison A Divanovic; Nelangi M Pinto Journal: Am J Cardiol Date: 2015-07-29 Impact factor: 2.778
Authors: Joyce T Johnson; Lloyd Y Tani; Michael D Puchalski; Tyler R Bardsley; Janice L B Byrne; L LuAnn Minich; Nelangi M Pinto Journal: Pediatr Cardiol Date: 2014-06-04 Impact factor: 1.655
Authors: J Marc Simard; Kevin N Sheth; W Taylor Kimberly; Barney J Stern; Gregory J del Zoppo; Sven Jacobson; Volodymyr Gerzanich Journal: Neurocrit Care Date: 2014-04 Impact factor: 3.210