Intravenous thrombolysis in the emergency department for the treatment of acute ischaemic stroke.
Emerg Med J
; 25(7): 403-6, 2008 Jul.
Article
en En
| MEDLINE
| ID: mdl-18573948
ABSTRACT
BACKGROUND AND AIMS:
Thrombolytic therapy with intravenous recombinant tissue plasminogen activator (rt-PA) improves outcome in patients with ischaemic stroke treated within 3 h of symptom onset, but its extended implementation is limited. A pilot study was designed to verify whether evaluation of patients with acute ischaemic stroke and their treatment with intravenous rt-PA in the emergency department (ED), followed by transportation to a semi-intensive stroke care unit, offers a safe and effective organisational solution to provide intravenous thrombolysis to acute stroke patients when a stroke unit (SU) is not available.METHODS:
After checking for inclusion and exclusion criteria, ED doctors contacted the stroke team with a single page, located family members and urgently obtained computed tomography scan and laboratory tests. A stroke team investigator clinically assessed the patient, obtained written informed consent and supervised intravenous rt-PA in the ED. After treatment, the patient was transferred to the SU for rehabilitation and treatment of complications, under supervision of the same stroke team investigator.RESULTS:
52 patients were treated with intravenous rt-PA within 3 h of symptom onset. 20 patients (38%) improved neurologically after 24 h, the number increased to 30 (58%) after one week. At 3 months 22 patients had a favourable outcome (43%). The 3-month mortality rate was 12%. Symptomatic cerebral haemorrhage was observed in two patients (4%).CONCLUSIONS:
Intravenous rt-PA administration in the ED is an effective organisational solution for acute ischaemic stroke when an SU is not established.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Isquemia Encefálica
/
Activador de Tejido Plasminógeno
/
Accidente Cerebrovascular
/
Fibrinolíticos
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
Límite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Emerg Med J
Asunto de la revista:
MEDICINA DE EMERGENCIA
Año:
2008
Tipo del documento:
Article
País de afiliación:
Italia