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Mortality in patients treated by intra-venous thrombolysis for ischaemic stroke.
MedLine Citation:
PMID:  23389413     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
In patients treated by intravenous (i.v.) thrombolysis, mortality rates range from 10 to 20 % at 3 months. The objective of this study was to determine the timing, causes and predictors of early (within 7 days) and delayed (8 days to 3 months) death after i.v. thrombolysis for cerebral ischaemia. We analyzed timing, causes and predictors of early and delayed mortality in a hospital-based registry of consecutive patients treated by i.v. thrombolysis for cerebral ischaemia. Of 500 patients (246 men; median age 71 years; median baseline National Institutes of Health Stroke Scale score 12; median onset-to-needle time 148 min), 76 (15.2 %; 95 % confidence interval [CI]: 12.3-18.6 %) died within 3 months. Of 29 patients with early death, 21 (72.4 %; 95 % CI: 54.3-85.3 %) died from neurovascular causes. Factors independently associated with early death were neurological complications and having had transient ischaemic attacks within the last 7 days. Of 47 patients with delayed death, 24 (51.1 %; 95 % CI: 37.2-64.7 %) died from infection, all but 1 having a modified Rankin scale >4 at 7 days. Factors independently associated with delayed death were pre-existing conditions and infections. Early and delayed mortality in ischaemic stroke patients are is highly dependent on the neurological status and response to thrombolysis. The target for reducing mortality is therefore to improve response to thrombolysis by any means, which can currently be achieved only by reducing delays.
Authors:
Loubna Majhadi; Didier Leys; Marie Bodenant; Hilde Hénon; Régis Bordet; Charlotte Cordonnier
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-7
Journal Detail:
Title:  Journal of neurology     Volume:  -     ISSN:  1432-1459     ISO Abbreviation:  J. Neurol.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0423161     Medline TA:  J Neurol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Departments of Neurology, Lille University Hospital, Université Lille Nord de France, UDSL, EA, 1046, Lille, France.
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