American Journal of Preventive Medicine
Results of stroke registryWhy Are Eligible Thrombolysis Candidates Left Untreated?
Section snippets
Data Collection
Data for this study were collected as part of the California Acute Stroke Prototype Registry (CASPR) sponsored by the Centers for Disease Control and Prevention (CDC) and have been described in detail elsewhere.18 In brief, the stroke registry included all patients with a diagnosis of suspected acute stroke or transient ischemic attack admitted to the emergency department (ED) of one of 11 study hospitals during two 3-month periods; November 1, 2002 to January 31, 2003 (Year 1) and November 1,
Results
Of 625 registry patients with acute ischemic stroke, 136 (22%) arrived at the ED within 2.5 hours of symptom onset, 380 (61%) arrived more than 2.5 hours after symptom onset, and 109 (17%) had an indeterminable time of symptom onset. Excluded were 10 patients who arrived within 2.5 hours: 6 patients who received thrombolysis outside of the 3-hour time window (the interval between stroke onset and treatment ranged from 3.15 hours to 6.25 hours), and 4 patients who received an acute intervention
Discussion
In the initial analysis (among 72 patients with ischemic stroke who both arrived within 2.5 hours of symptom onset and had no directly documented contraindication) it was found that only 44% were treated with thrombolysis. Several predictors of nontreatment were identified, including older age and later arrival at the ED after symptom onset. Results were similar after a sensitivity analysis was performed, using data in which eligibility was reclassified based on careful examination and full
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