Time to treatment with recombinant tissue plasminogen activator and outcome of stroke in clinical practice: Retrospective analysis of hospital quality assurance data with comparison with results from randomised clinical trials

BMJ (Online)

Volumn 348, Issue , 2014, Pages

  Gumbinger, Christoph ^a   Reuter, Björn ^a   Stock, Christian ^a   Sauer, Tamara ^a   Wiethölter, Horst ^b   Bruder, Ingo ^c   Rode, Susanne ^c   Kern, Rolf ^a   Ringleb, Peter ^a   Hennerici, Michael G ^a   Hacke, Werner ^a  

^a UNIVERSITY OF HEIDELBERG   (Germany)

^b Department of Neurology Mannheim University of Heidelberg ^*

^c Rehabilitation and Organization Division   (Germany)

Author keywords

[No Author keywords available]

Indexed keywords

ALTEPLASE; FIBRINOLYTIC AGENT; RECOMBINANT PROTEIN; TISSUE PLASMINOGEN ACTIVATOR;

AGED; ARTICLE; BRAIN ISCHEMIA; CHRONOTHERAPY; CLINICAL EFFECTIVENESS; CLINICAL PRACTICE; COHORT ANALYSIS; CORRELATIONAL STUDY; DRUG EFFICACY; DRUG SAFETY; EARLY INTERVENTION; FEMALE; FIBRINOLYTIC THERAPY; GERMANY; HEALTH CARE QUALITY; HUMAN; MAJOR CLINICAL STUDY; MALE; MORTALITY; NUMBERS NEEDED TO TREAT; OUTCOME ASSESSMENT; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); RETROSPECTIVE STUDY; TIME TO TREATMENT; MIDDLE AGED; PROCEDURES; STATISTICAL MODEL; STROKE; VERY ELDERLY;

AGED; AGED, 80 AND OVER; BRAIN ISCHEMIA; FEMALE; FIBRINOLYTIC AGENTS; GERMANY; HOSPITAL MORTALITY; HUMANS; LOGISTIC MODELS; MALE; MIDDLE AGED; OUTCOME ASSESSMENT (HEALTH CARE); QUALITY ASSURANCE, HEALTH CARE; RANDOMIZED CONTROLLED TRIALS AS TOPIC; RECOMBINANT PROTEINS; RETROSPECTIVE STUDIES; STROKE; TIME-TO-TREATMENT; TISSUE PLASMINOGEN ACTIVATOR;

EID: 84901724133     PISSN: None     EISSN: 17561833     Source Type: Journal    
DOI: 10.1136/bmj.g3429     Document Type: Article

References (25)

1. National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 1995;333:1581-8.
2. Hacke W, Kaste M, Bluhmki E, Brozman M, Dávalos A, Guidetti D, et al. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med 2008;359:1317-29.
3. Hacke W, Donnan G, Fieschi C, Kaste M, Kummer R von, Broderick JP, et al. Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. Lancet 2004;363:768-74.
4. Lees KR, Bluhmki E, Kummer R von, Brott TG, Toni D, Grotta JC, et al. Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials. Lancet 2010;375:1695-703.
5. Emberson JR, Hacke W. Impact of treatment delay, age and stroke severity on the effects of intravenous thrombolysis with altepase in acute ischemic stroke: an individual-patient-data meta-analysis. ISC 2014, San Diego, CA, Feb 12-14, 2014.
6. Strbian D, Soinne L, Sairanen T, Happola O, Lindsberg PJ, Tatlisumak T, et al. Ultraearly thrombolysis in acute ischemic stroke is associated with better outcome and lower mortality. Stroke 2010;41:712-6.
7. Saposnik G, Di Legge S, Webster F, Hachinski V. Predictors of major neurologic improvement after thrombolysis in acute stroke. Neurology 2005;65:1169-74. (Pubitemid 41508205)
8. Sobesky J, Frackowiak M, Zaro Weber O, Hahn M, Moller-Hartmann W, Rudolf J, et al. The Cologne stroke experience: safety and outcome in 450 patients treated with intravenous thrombolysis. Cerebrovasc Dis 2007;24:56-65. (Pubitemid 47026142)
9. Ahmed N, Wahlgren N, Grond M, Hennerici M, Lees KR, Mikulik R, et al. Implementation and outcome of thrombolysis with alteplase 3-4 5 h after an acute stroke: an updated analysis from SITS-ISTR. Lancet Neurol 2010;9:866-74.
10. Ahmed N. Results of intravenous thrombolysis within 4.5 to 6 hours and updated results within 3 to 4.5 hours of onset of acute ischemic stroke recorded in the Safe Implementation of Treatment in Stroke International Stroke Thrombolysis Register (SITS-ISTR): an observational study. Results of intravenous thrombolysis results of intravenous thrombolysis. JAMA Neurol 2013;70:837.
11. Gumbinger C, Reuter B, Wiethölter H, Bruder I, Rode S, Drewitz E, et al. A consecutive and prospective stroke database covers the state of Baden-Wuerttemberg with 10.8 million inhabitants in Germany. Neuroepidemiology 2013;41:161-8.
12. Brott T, Adams HP, Olinger CP, Marler JR, Barsan WG, Biller J, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke 1989;20:864-70. (Pubitemid 19188240)
13. Palm F, Urbanek C, Rose S, Buggle F, Bode B, Hennerici MG, et al. Stroke Incidence and Survival in Ludwigshafen am Rhein, Germany: the Ludwigshafen Stroke Study (LuSSt). Stroke 2010;41:1865-70.
14. Bender R, Blettner M. Calculating the "number needed to be exposed" with adjustment for confounding variables in epidemiological studies. J Clin Epidemiol 2002;55:525-30. (Pubitemid 34462249)
15. Ovbiagele B, Saver JL. Day-90 acute ischemic stroke outcomes can be derived from early functional activity level. Cerebrovasc Dis 2010;29:50-6.
16. Bath PMW, Lees KR, Schellinger PD, Altman H, Bland M, Hogg C, et al. Statistical analysis of the primary outcome in acute stroke trials. Stroke 2012;43:1171-8.
17. Saver JL. Novel end point analytic techniques and interpreting shifts across the entire range of outcome scales in acute stroke trials. Stroke 2007;38:3055-62. (Pubitemid 350035704)
18. European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. Cerebrovasc Dis 2008;25:457-507.
19. Saver JL. Time to treatment with intravenous tissue plasminogen activator and outcome from acute ischemic stroke time to treatment with IV tPA and ischemic stroke. JAMA 2013;309:2480.
20. Wahlgren N, Ahmed N, Dávalos A, Hacke W, Millán M, Muir K, et al. Thrombolysis with alteplase 3-4 5 h after acute ischaemic stroke (SITS-ISTR): an observational study. Lancet 2008;372:1303-9.
21. Wahlgren N, Ahmed N, Dávalos A, Ford GA, Grond M, Hacke W, et al. Thrombolysis with alteplase for acute ischaemic stroke in the safe implementation of thrombolysis in stroke-monitoring study (SITS-MOST): an observational study. Lancet 2007;369:275-82. (Pubitemid 46138121)
22. IST-3 collaborative group, Sandercock P, Wardlaw JM, Lindley RI, Dennis M, Cohen G, et al. The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial [IST-3]): a randomised controlled trial. Lancet 2012;379:2352-63.
23. Dirks M, Dippel DWJ. Implementation of thrombolysis for ischaemic stroke. Lancet Neurol 2013;12:120-1.
24. Scott PA, Meurer WJ, Frederiksen SM, Kalbfleisch JD, Xu Z, Haan MN, et al. A multilevel intervention to increase community hospital use of alteplase for acute stroke (INSTINCT): a cluster-randomised controlled trial. Lancet Neurol 2013;12:139-48.
25. Meretoja A, Strbian D, Mustanoja S, Tatlisumak T, Lindsberg PJ, Kaste M. Reducing in-hospital delay to 20 minutes in stroke thrombolysis. Neurology 2012;79:306-13.