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Clinical outcomes of acute stroke thrombolysis in neurologist and non-neurologist centres - A comparative study in Malaysia.
Chew, S H; Looi, I; Neoh, K K; Ooi, J; Cheah, W K; Zariah, A A.
Afiliação
  • Chew SH; Seberang Jaya Hospital, Department of Internal Medicine, Penang, Malaysia. sinhong06@gmail.com.
  • Looi I; Seberang Jaya Hospital, Department of Internal Medicine, Penang, Malaysia.
  • Neoh KK; Seberang Jaya Hospital, Department of Internal Medicine, Penang, Malaysia.
  • Ooi J; Seberang Jaya Hospital, Clinical Research Centre, Penang, Malaysia.
  • Cheah WK; Taiping Hospital, Department of Internal Medicine, Taiping, Perak, Malaysia.
  • Zariah AA; Sultanah Nur Zahirah Hospital, Department of Medicine, Kuala Terengganu, Malaysia.
Med J Malaysia ; 76(1): 12-16, 2021 01.
Article em En | MEDLINE | ID: mdl-33510102
ABSTRACT

BACKGROUND:

Thrombolytic therapy with intravenous alteplase is a well-established treatment for acute ischaemic stroke (AIS). However, in Malaysia, treatment prescription is often limited by the availability of neurologists. The objective was to compare the outcomes of acute stroke thrombolysis therapy prescribed by neurologists in the Seberang Jaya Hospital (SJH) and non-neurologists in the Taiping Hospital (TH).

METHODS:

In this cross-sectional study, all AIS patients who received thrombolytic therapy in SJH and TH between January 2012 and September 2019 were included. Clinical data was extracted from admission records. The outcomes assessed were the percentage of patients who achieved excellent functional outcome at 3 months (modified Rankin scale of 0 to 1), rates of symptomatic intracranial haemorrhage (SICH), and mortality.

RESULTS:

A total of 63 AIS patients who received thrombolytic therapy were included, of which 37 patients (58.7%) were treated in SJH. The median NIHSS on admission was 12 in SJH and 11.5 in TH. In all 21.6% of patients from SJH and 30.7% of patients from TH achieved favourable functional outcome at 3 months (p=0.412). There were no significant differences between the two centres in terms of the rates of SICH (10.8% in SJH and 3.8% in TH, p=0.314) and 3-month mortality (24.3% versus 12.5%, p=0.203).

CONCLUSION:

The 3-month functional outcomes and complication rates of stroke thrombolysis in hospitals with or without neurologists are not significantly different. Thus non-neurologist hospitals may be able to provide thrombolysis service to AIS patients safely and effectively.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Isquemia Encefálica / Acidente Vascular Cerebral Tipo de estudo: Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Humans País/Região como assunto: Asia Idioma: En Revista: Med J Malaysia Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Malásia
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Isquemia Encefálica / Acidente Vascular Cerebral Tipo de estudo: Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Humans País/Região como assunto: Asia Idioma: En Revista: Med J Malaysia Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Malásia