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Dissemination of Thrombolysis for Acute Ischemic Stroke Across a Nation. Experiences From the Swedish Stroke Register, 2003 to 2008.

Eriksson, Marie ; Jonsson, Fredrik ; Appelros, Peter ; Asberg, Kerstin Hulter ; Norrving, Bo LU ; Stegmayr, Birgitta ; Terént, Andreas and Asplund, Kjell (2010) In Stroke: a journal of cerebral circulation 41(6). p.1115-1122
Abstract
BACKGROUND AND PURPOSE: We used Riks-Stroke, the Swedish Stroke Register, to explore how thrombolysis has been disseminated in Swedish hospitals since it was approved in 2003. METHODS: All 78 hospitals in Sweden admitting patients with acute stroke participate in Riks-Stroke. Between 2003 and 2008, 72 033 adult patients were hospitalized for acute ischemic stroke. We analyzed thrombolysis use by region, patient characteristics, and stroke service settings. RESULTS: Nationwide, the use of thrombolysis increased from 0.9% in 2003 to 6.6% in 2008. There were marked regional differences in the dissemination of thrombolysis, but these gaps narrowed over time. Nonuniversity hospitals reached treatment levels similar to university settings,... (More)
BACKGROUND AND PURPOSE: We used Riks-Stroke, the Swedish Stroke Register, to explore how thrombolysis has been disseminated in Swedish hospitals since it was approved in 2003. METHODS: All 78 hospitals in Sweden admitting patients with acute stroke participate in Riks-Stroke. Between 2003 and 2008, 72 033 adult patients were hospitalized for acute ischemic stroke. We analyzed thrombolysis use by region, patient characteristics, and stroke service settings. RESULTS: Nationwide, the use of thrombolysis increased from 0.9% in 2003 to 6.6% in 2008. There were marked regional differences in the dissemination of thrombolysis, but these gaps narrowed over time. Nonuniversity hospitals reached treatment levels similar to university settings, although with a 2- to 3-year delay. Symptomatic intracranial hemorrhage remained at the 3% to 9% level without an apparent time trend during dissemination. Independent predictors of higher thrombolysis use included younger age, male sex, not living alone, and no history of stroke or diabetes. In 2008, patients admitted to a stroke unit were 5 times more likely to receive thrombolysis than those admitted to general wards. CONCLUSIONS: Nationwide implementation of thrombolysis has been slow but has accelerated mainly due to increased access outside university hospitals. The increased use has been achieved safely, but access has been unequal. (Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
thrombolysis, implementation, acute ischemic stroke
in
Stroke: a journal of cerebral circulation
volume
41
issue
6
pages
1115 - 1122
publisher
American Heart Association
external identifiers
  • wos:000278019400010
  • pmid:20395610
  • scopus:77953157932
  • pmid:20395610
ISSN
1524-4628
DOI
10.1161/STROKEAHA.109.577106
language
English
LU publication?
yes
id
2444f673-96b1-4ab6-87d1-eabcd4d04bda (old id 1595206)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20395610?dopt=Abstract
date added to LUP
2016-04-01 14:57:34
date last changed
2022-03-22 02:47:04
@article{2444f673-96b1-4ab6-87d1-eabcd4d04bda,
  abstract     = {{BACKGROUND AND PURPOSE: We used Riks-Stroke, the Swedish Stroke Register, to explore how thrombolysis has been disseminated in Swedish hospitals since it was approved in 2003. METHODS: All 78 hospitals in Sweden admitting patients with acute stroke participate in Riks-Stroke. Between 2003 and 2008, 72 033 adult patients were hospitalized for acute ischemic stroke. We analyzed thrombolysis use by region, patient characteristics, and stroke service settings. RESULTS: Nationwide, the use of thrombolysis increased from 0.9% in 2003 to 6.6% in 2008. There were marked regional differences in the dissemination of thrombolysis, but these gaps narrowed over time. Nonuniversity hospitals reached treatment levels similar to university settings, although with a 2- to 3-year delay. Symptomatic intracranial hemorrhage remained at the 3% to 9% level without an apparent time trend during dissemination. Independent predictors of higher thrombolysis use included younger age, male sex, not living alone, and no history of stroke or diabetes. In 2008, patients admitted to a stroke unit were 5 times more likely to receive thrombolysis than those admitted to general wards. CONCLUSIONS: Nationwide implementation of thrombolysis has been slow but has accelerated mainly due to increased access outside university hospitals. The increased use has been achieved safely, but access has been unequal.}},
  author       = {{Eriksson, Marie and Jonsson, Fredrik and Appelros, Peter and Asberg, Kerstin Hulter and Norrving, Bo and Stegmayr, Birgitta and Terént, Andreas and Asplund, Kjell}},
  issn         = {{1524-4628}},
  keywords     = {{thrombolysis; implementation; acute ischemic stroke}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{1115--1122}},
  publisher    = {{American Heart Association}},
  series       = {{Stroke: a journal of cerebral circulation}},
  title        = {{Dissemination of Thrombolysis for Acute Ischemic Stroke Across a Nation. Experiences From the Swedish Stroke Register, 2003 to 2008.}},
  url          = {{http://dx.doi.org/10.1161/STROKEAHA.109.577106}},
  doi          = {{10.1161/STROKEAHA.109.577106}},
  volume       = {{41}},
  year         = {{2010}},
}