Reasons for non-thrombolysis divided by onset-to-admission delay (≤180 min vs >180 min)
| Arrival | OR | 95% CI | ||||
|---|---|---|---|---|---|---|
| ≤180 min (n=659) | >180 min (n=1360) | |||||
| Patient characteristics | ||||||
| Age (median quartiles) | 73 | 61, 82 | 73 | 60, 82 | 1.00 | 0.99 to 1.01 |
| Sex (male) | 393 | 59.6% | 699 | 51.4% | 1.24* | 1.03 to 1.50 |
| Admission NIHSS (median quartiles) | 4.5 | 2, 11 | 5 | 2, 10 | 1.00 | 0.99 to 1.00 |
| Stroke mechanism (TOAST)† | ||||||
| Atherosclerosis with ≥50% (NASCET) stenosis | 87 | 13.2% | 158 | 11.6% | 1.08 | 0.82 to 1.43 |
| Likely atherosclerosis/aortic, without significant stenosis‡ | 89 | 13.5% | 203 | 14.9% | 0.83 | 0.63 to 1.08 |
| Cardioembolism | 203 | 30.8% | 355 | 26.1% | 1.16 | 0.95 to 1.43 |
| Small vessel occlusion | 75 | 11.4% | 233 | 17.1% | 0.58* | 0.44 to 0.76 |
| Dissections | 24 | 3.6% | 49 | 3.6% | 0.95 | 0.58 to 1.56 |
| Other determined | 54 | 8.2% | 32 | 2.4% | 3.49* | 2.23 to 5.46 |
| Undetermined mechanism | 57 | 8.6% | 121 | 8.9% | 0.91 | 0.65 to 1.26 |
| Multiple mechanisms | 39 | 5.9% | 56 | 4.1% | 1.38 | 0.90 to 2.10 |
| PFO as likely cause | 19 | 2.9% | 50 | 3.7% | 0.73 | 0.43 to 1.25 |
| Reason: severity | ||||||
| Too mild | 323 | 49.0% | 567 | 41.7% | 1.22* | 1.01 to 1.47 |
| Too severe | 12 | 1.8% | 12 | 0.9% | 1.97 | 0.88 to 4.40 |
| Rapid improvement to below threshold | 15 | 2.3% | 3 | 0.2% | 9.94* | 2.87 to 34.48 |
| Total | 350 | 53.1% | 582 | 42.8% | 1.37* | 1.13 to 1.66 |
| Reason: age | ||||||
| >80 years | 112 | 17.0% | 164 | 12.1% | 1.40* | 1.08 to 1.82 |
| Reason: imaging | ||||||
| Too large infarct | 3 | 0.5% | 27 | 2.0% | 0.21* | 0.06 to 0.70 |
| Too little penumbra | 6 | 0.9% | 6 | 0.4% | 1.96 | 0.63 to 6.09 |
| Too large infarct and too little penumbra | 3 | 0.5% | 3 | 0.2% | 1.95 | 0.39 to 9.70 |
| Subacute infarct on imaging | 12 | 1.8% | 5 | 0.4% | 4.74* | 1.66 to 13.52 |
| Other/intracranial haemorrhage | 10 | 1.5% | 13 | 1.0% | 1.51 | 0.66 to 3.45 |
| Total | 34 | 5.2% | 54 | 4.0% | 1.24 | 0.80 to 1.92 |
| Reason: high bleeding risk | ||||||
| INR elevated | 71 | 10.8% | 96 | 7.1% | 1.49* | 1.08 to 2.06 |
| Thrombocytopenia | 2 | 0.3% | 4 | 0.3% | 0.97 | 0.18 to 5.33 |
| Recent intervention | 16 | 2.4% | 3 | 0.2% | 10.62* | 3.08 to 36.60 |
| Previous intracranial haemorrhage | 10 | 1.5% | 6 | 0.4% | 3.28* | 1.19 to 9.07 |
| Intracranial vascular malformation | 5 | 0.8% | 9 | 0.7% | 1.08 | 0.36 to 3.24 |
| Other | 15 | 2.3% | 9 | 0.7% | 3.30* | 1.44 to 7.58 |
| Full dose heparin or LMWH | 17 | 2.6% | 3 | 0.2% | 11.31* | 3.30 to 38.72 |
| Total | 136 | 20.6% | 130 | 9.6% | 2.31* | 1.78 to 3.00 |
| Reason: other | ||||||
| No good reason according to hospital recommendations | 45 | 6.8% | 10 | 0.7% | 9.34* | 4.68 to 18.66 |
| Recent stroke | 36 | 5.5% | 13 | 1.0% | 5.65* | 2.98 to 10.73 |
| Stroke uncertain | 26 | 3.9% | 29 | 2.1% | 1.78* | 1.04 to 3.04 |
| Epileptic seizure | 7 | 1.1% | 4 | 0.3% | 3.43* | 1.00 to 11.78 |
| Comorbidity/dependency | 38 | 5.8% | 43 | 3.2% | 1.77* | 1.13 to 2.76 |
| Total | 152 | 23.1% | 99 | 7.3% | 3.97* | 1.69 to 9.32 |
Asterisk (*), significant on p<0.05 level. Definitions of reasons for non-thrombolysis see text/table 5.
†TOAST17 classification.
‡Ipsilateral internal carotid stenosis <50%(NASCET)/risk factors for atherosclerotic disease, for details see PERFORM definition.18
INR, International Normalised Ratio; LMWH, low molecular weight heparin; NIHSS, National Institute of Health Stroke Scale score; PFO, patent foramen ovale; TOAST, Trial of Org 10172 in Acute Stroke Treatment.