Effects of Extending the Time Window of Thrombolysis to 4.5 Hours: Observations in the Swedish Stroke Register (Riks-Stroke).
(2011) In Stroke: a journal of cerebral circulation 42(9). p.2492-2497- Abstract
- BACKGROUND AND PURPOSE:
The European Cooperative Acute Stroke Study (ECASS) III trial and Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register (SITS-ISTR) data were published in 2008. Riks-Stroke, the Swedish Stroke Register, was used to explore how thrombolysis in the 3- to 4.5-hour window has been spread in different hospitals and patient groups and what effects this has had on treatment within 3 hours.
METHODS:
All 76 hospitals in Sweden admitting patients with acute stroke participate in Riks-Stroke. During the study period, January 2003 to June 2010, 92 150 18- to 80-year-old patients were hospitalized for acute ischemic stroke.
... (More) - BACKGROUND AND PURPOSE:
The European Cooperative Acute Stroke Study (ECASS) III trial and Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register (SITS-ISTR) data were published in 2008. Riks-Stroke, the Swedish Stroke Register, was used to explore how thrombolysis in the 3- to 4.5-hour window has been spread in different hospitals and patient groups and what effects this has had on treatment within 3 hours.
METHODS:
All 76 hospitals in Sweden admitting patients with acute stroke participate in Riks-Stroke. During the study period, January 2003 to June 2010, 92 150 18- to 80-year-old patients were hospitalized for acute ischemic stroke.
RESULTS:
After the publication of the ECASS III results in the third quarter of 2008, thrombolysis in the 3- to 4.5-hour window increased from 0.5% before publication to 2.1% in 2010. Thrombolysis in the 3- to 4.5-hour window spread somewhat faster in men than women (P=0.04) but at a similar rate in different age groups. The use of thrombolysis within 3 hours after onset of symptoms increased successively from 0.9% in 2003 to 6.6% in late 2008 and then it stabilized at 6%. The median time from arrival to the hospital to start of treatment remained unchanged at 66 to 69 minutes before and after 2008 (P=0.06).
CONCLUSIONS:
Since the end of 2008, there has been a rapid nationwide dissemination of thrombolysis in the 3- to 4.5-hour window, whereas rates in the <3-hour window have leveled off. The extended time window has not affected door-to-needle time. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/2151704
- author
- Asplund, Kjell ; Glader, Eva-Lotta ; Norrving, Bo LU and Eriksson, Marie
- organization
- publishing date
- 2011
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- thrombolysis, rtPA, implementation, acute ischemic stroke, delay of treatment
- in
- Stroke: a journal of cerebral circulation
- volume
- 42
- issue
- 9
- pages
- 2492 - 2497
- publisher
- American Heart Association
- external identifiers
-
- wos:000294342800032
- pmid:21799155
- scopus:80052414466
- pmid:21799155
- ISSN
- 1524-4628
- DOI
- 10.1161/STROKEAHA.111.618587
- language
- English
- LU publication?
- yes
- id
- 1cecea07-ac56-4dfa-925d-6617b9874646 (old id 2151704)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/21799155?dopt=Abstract
- date added to LUP
- 2016-04-01 14:56:34
- date last changed
- 2022-01-28 03:15:34
@article{1cecea07-ac56-4dfa-925d-6617b9874646, abstract = {{BACKGROUND AND PURPOSE:<br/><br> The European Cooperative Acute Stroke Study (ECASS) III trial and Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register (SITS-ISTR) data were published in 2008. Riks-Stroke, the Swedish Stroke Register, was used to explore how thrombolysis in the 3- to 4.5-hour window has been spread in different hospitals and patient groups and what effects this has had on treatment within 3 hours.<br/><br> <br/><br> METHODS:<br/><br> All 76 hospitals in Sweden admitting patients with acute stroke participate in Riks-Stroke. During the study period, January 2003 to June 2010, 92 150 18- to 80-year-old patients were hospitalized for acute ischemic stroke.<br/><br> <br/><br> RESULTS:<br/><br> After the publication of the ECASS III results in the third quarter of 2008, thrombolysis in the 3- to 4.5-hour window increased from 0.5% before publication to 2.1% in 2010. Thrombolysis in the 3- to 4.5-hour window spread somewhat faster in men than women (P=0.04) but at a similar rate in different age groups. The use of thrombolysis within 3 hours after onset of symptoms increased successively from 0.9% in 2003 to 6.6% in late 2008 and then it stabilized at 6%. The median time from arrival to the hospital to start of treatment remained unchanged at 66 to 69 minutes before and after 2008 (P=0.06).<br/><br> <br/><br> CONCLUSIONS:<br/><br> Since the end of 2008, there has been a rapid nationwide dissemination of thrombolysis in the 3- to 4.5-hour window, whereas rates in the <3-hour window have leveled off. The extended time window has not affected door-to-needle time.}}, author = {{Asplund, Kjell and Glader, Eva-Lotta and Norrving, Bo and Eriksson, Marie}}, issn = {{1524-4628}}, keywords = {{thrombolysis; rtPA; implementation; acute ischemic stroke; delay of treatment}}, language = {{eng}}, number = {{9}}, pages = {{2492--2497}}, publisher = {{American Heart Association}}, series = {{Stroke: a journal of cerebral circulation}}, title = {{Effects of Extending the Time Window of Thrombolysis to 4.5 Hours: Observations in the Swedish Stroke Register (Riks-Stroke).}}, url = {{http://dx.doi.org/10.1161/STROKEAHA.111.618587}}, doi = {{10.1161/STROKEAHA.111.618587}}, volume = {{42}}, year = {{2011}}, }