Document Detail


Thrombolysis for acute stroke in Australia: outcomes from the Safe Implementation of Thrombolysis in Stroke registry (2002-2008).
MedLine Citation:
PMID:  20955119     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To report Australian outcomes from the Safe Implementation of Thrombolysis in Stroke International Stroke Thrombolysis Register (SITS-ISTR).
DESIGN: Observational study using data collected prospectively from December 2002 to December 2008.
SETTING: Centres administering thrombolysis for acute stroke in Australia and worldwide.
PATIENTS: All patients treated with recombinant tissue plasminogen activator for acute stroke in participating centres, regardless of stroke severity, time of treatment and other clinical factors.
INTERVENTION: Thrombolysis for acute stroke, administered according to local protocol.
MAIN OUTCOME MEASURES: Functional outcome as 3-month modified Rankin score (mRS), and frequency of symptomatic intracerebral haemorrhage (ICH).
RESULTS: During the study period, a total of 32 countries participated, and confirmed baseline data were available for 581 Australian patients and 20 953 patients in the rest of the world. Australian patients were older (median age, 73 v 69 years; P < 0.001), were less independent before stroke (premorbid mRS of 0-1, 87.5% v 91.2%; P < 0.005), and had more comorbidities and more severe strokes. Comparing the Australian cohort with the rest of the world, the odds ratio of 3-month mRS of 0-2 was 0.98 (95% CI, 0.88-1.08; P = 0.63), the odds ratio of symptomatic ICH was 0.98 (95% CI, 0.83-1.16; P = 0.85 [by the definition used by the National Institute of Neurological Disorders]) and the odds ratio of death was 1.04 (95% CI, 0.91-1.19; P = 0.54). Good outcome in the Australian cohort was predicted by younger age, presence of hyperlipidaemia, lower premorbid mRS, absence of infarct on early brain imaging, less severe stroke, and lower baseline blood glucose level.
CONCLUSION: Clinical outcomes after thrombolysis in Australia were similar to those worldwide.
Authors:
Marion A Simpson; Helen M Dewey; Leonid Churilov; Niaz Ahmed; Christopher F Bladin; David Schultz; Romesh Markus; Jonathan W Sturm; Christopher R Levi; David J Blacker; Jim Jannes; Richard I Lindley; Mark W Parsons
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Medical journal of Australia     Volume:  193     ISSN:  0025-729X     ISO Abbreviation:  Med. J. Aust.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-19     Completed Date:  2010-11-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400714     Medline TA:  Med J Aust     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  439-43     Citation Subset:  IM    
Affiliation:
Department of Neurology, Austin Health, Melbourne, VIC, Australia. marion.simpson@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Aged, 80 and over
Australia
Female
Fibrinolytic Agents / adverse effects,  therapeutic use*
Humans
Male
Middle Aged
Registries
Stroke / drug therapy*
Thrombolytic Therapy* / adverse effects
Tissue Plasminogen Activator / adverse effects,  therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; EC 3.4.21.68/Tissue Plasminogen Activator
Comments/Corrections
Comment In:
Med J Aust. 2010 Oct 18;193(8):436-7   [PMID:  20955117 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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