Mortality of stroke patients treated with thrombolysis: Analysis of nationwide inpatient sample

@article{Dubinsky2006MortalityOS,
  title={Mortality of stroke patients treated with thrombolysis: Analysis of nationwide inpatient sample},
  author={Richard Dubinsky and Sue Min Lai},
  journal={Neurology},
  year={2006},
  volume={66},
  pages={1742 - 1744}
}
The authors performed a retrospective cohort comparison using the Nationwide Inpatient Sample for 1999 through 2002 of acute ischemic stroke admissions. Mortality was compared based on the use of thrombolysis. Hospital mortality was significantly greater for the thrombolysis cohort (10.1% vs 5.8%) as was the rate of secondary intracranial hemorrhage (4.2% vs 0.4%). US community experience in the use of thrombolysis has higher rates of complications and mortality than in controlled clinical… 

Tables from this paper

Is Thrombolysis Safe in the Elderly?: Analysis of a National Database
TLDR
Despite the higher mortality rate in the older population, the use of thrombolysis does not predict death; however, the presence of ICH was associated with high risk of I CH.
Comparison of Short-term Outcomes of Thrombolysis for In-Hospital Stroke and Out-of-Hospital Stroke in United States
TLDR
Thrombolysis is not associated with a higher rate of intracerebral hemorrhage among IHS, and the demographic and hospital characteristics, comorbidities, and short-term outcomes of thrombolysed IHS and OHS are similar.
Thrombolytic utilization for ischemic stroke in US hospitals with neurology residency program
TLDR
Acute stroke care in NR hospitals is associated with an increased thrombolytic utilization, and the disparities between the throm bolysis rate in NR and that in OT and NT hospitals are greater among elderly patients.
Does dementia increase risk of thrombolysis?
TLDR
The administration of thrombolysis for AIS in patients with dementia was not associated with increased risk of intracerebral hemorrhage or death compared to the counterparts without dementia, and ICH remained as predictor of mortality.
A population‐based study of thrombolysis for acute stroke in South Australia
  • D. Fatovich
  • Medicine
    The Medical journal of Australia
  • 2011
TLDR
The report by Leyden and colleagues highlights the value of examining the total experience of stroke thrombolysis in one population, but the results are devastating: protocol violations in more than a third of cases, and a 10% symptomatic intracranial haemorrhage rate.
A population‐based study of thrombolysis for acute stroke in South Australia
TLDR
A large proportion of South Australians are currently missing out on acute stroke therapy as a result of poor access to acute stroke units in both urban and rural settings, and it is estimated that fewer than 2% of ischaemic stroke patients are administered thrombolysis.
Comparing hospitals on stroke care: the need to account for stroke severity.
TLDR
Evaluating the influence of including or excluding stroke severity in prognostic stroke outcome models in a large Medicare insurance database shows that the model including stroke severity was superior, indicating that stroke severity substantially improved the prediction of 30-day mortality above and beyond other clinical predictors.
Thrombolysis is an Independent Risk Factor for Poor Outcome After Carotid Revascularization
TLDR
Thrombolysis is a strong risk factor for ICH, PPS, poor outcome, and in-hospital mortality in patients with carotid stenosis/occlusion who undergo carotids revascularization, and Delayingcarotid revascularized in these patients may therefore be appropriate.
Management of acute ischaemic stroke in patients with dementia
TLDR
Current knowledge about the management of ischaemic stroke in patients with pre‐existing dementia is summarized, including organizational aspects of stroke care, intravenous thrombolysis, access to stroke unit care and use of supportive treatment.
...
1
2
3
...

References

SHOWING 1-10 OF 10 REFERENCES
Frequency of Thrombolytic Therapy in Patients With Acute Ischemic Stroke and the Risk of In-Hospital Mortality: The German Stroke Registers Study Group
TLDR
It is suggested that thrombolytic therapy in hospitals with limited experience in its application increase the risk of in-hospital mortality.
Treatment With Tissue Plasminogen Activator and Inpatient Mortality Rates for Patients With Ischemic Stroke Treated in Community Hospitals
TLDR
In this large, retrospective evaluation of community hospital practice, the use of intravenous tissue plasminogen activator (IV tPA) and inpatient mortality rates among IV tPA–treated patients were consistent with those of other studies.
Thrombolysis for acute stroke in routine clinical practice.
TLDR
Patients who receive thrombolysis with major protocol deviations have higher rates of in-hospital mortality and serious extracranial hemorrhage than patients in the NINDS cohort.
Intravenous tPA for Ischemic Stroke: Team Performance Over Time, Safety, and Efficacy in a Single-Center, 2-Year Experience
TLDR
Thrombolytic therapy can be performed safely and efficaciously in daily clinical routine and the performance of a stroke team can be improved over time, subsequently increasing the proportion of eligible patients and thereby the efficiency of the method.
Tissue Plasminogen Activator for Acute Ischemic Stroke in Clinical Practice: A Meta-Analysis of Safety Data
TLDR
Postapproval data support the safety of intravenous thrombolytic therapy with tPA for acute ischemic stroke, especially when established treatment guidelines are followed.
Use of tissue-type plasminogen activator for acute ischemic stroke: the Cleveland area experience.
TLDR
A small proportion of patients admitted with acute ischemic stroke in Cleveland received tPA; they experienced a high rate of ICH and in-hospital mortality was significantly higher among patients treated with tPA, and with mortality predicted by a model.
The Greater Cincinnati/Northern Kentucky Stroke Study: preliminary first-ever and total incidence rates of stroke among blacks.
TLDR
The incidence rates among blacks in Greater Cincinnati were substantially greater than the rates among whites in Rochester, Minn, for all age categories except ages 75 and older, for which the rates were similar.
Thrombolysis for acute ischaemic stroke (Cochrane Review)
  • 2003
Class size is limited to provide more personal instruction and live, small-group demonstration sessions. Attendees can obtain 7.0 hours of AMA PRA Category 1 credits
  • The American Academy of Neurology is offering workshops for Treatment of Dystonia and Spasticity, demonstrating the use of botulinum toxin