Table 7

Reasons for non-thrombolysis comparing the first with the second half of the observation period

Patients (n=2019)2003–2006 (n=959)2007–2011 (n=1060)OR95% CI
Patient characteristics
 Age (median quartiles)7360, 817461, 831.000.99 to 1.00
 Sex (male)53055.3%60156.7%0.940.79 to 1.13
 Admission NIHSS (median quartiles)53, 1242, 91.00*1.00 to 1.01
Stroke mechanism (TOAST)†
 Atherosclerosis with ≥50% (NASCET) stenosis10611.1%14713.9%0.73*0.56 to 0.95
 Likely atherosclerosis/aortic, without significant stenosis‡15115.7%15214.3%1.060.83 to 1.35
 Cardioembolism27728.9%30128.4%1.020.84 to 1.25
 Small vessel occlusion17117.8%14914.1%1.260.99 to 1.60
 Dissections454.7%302.8%1.61*1.01 to 2.58
 Other determined384.0%484.5%0.830.54 to 1.28
 Undetermined mechanism899.3%938.8%1.010.74 to 1.37
 Multiple mechanisms464.8%545.1%0.890.60 to 1.34
 PFO as likely cause353.6%363.4%1.030.64 to 1.65
Reason: time
 Too late intravenous252.6%262.5%1.040.59 to 1.81
 Too late intravenous and no indication intra-arterial12713.2%767.2%1.92*1.42 to 2.59
 Too late intravenous and intra-arterial20921.8%20919.7%1.100.88 to 1.36
 Unknown onset26827.9%39937.6%0.62*0.51 to 0.74
 Total62965.6%71067.0%0.860.72 to 1.04
Reason: severity
 Too mild44246.1%49746.9%0.970.82 to 1.16
 Too severe202.1%50.5%4.37*1.63 to 11.70
 Rapid improvement to below threshold161.7%20.2%8.73*2.00 to 38.08
 Total47849.8%48946.1%1.100.92 to 1.32
Reason: age
 >80 years18319.1%1029.6%2.15*1.66 to 2.79
Reason: imaging
 Too large infarct00.0%323.0%30.24*§, p=0.000
 Too little penumbra60.6%60.6%1.080.35 to 3.35
 Too large infarct and too little penumbra00.0%70.7%6.53*¶ , p=0.016
 Subacute infarct on imaging60.6%121.1%0.530.20 to 1.43
 Other/intracranial haemorrhage30.3%201.9%0.16*0.05 to 0.54
 Total151.6%777.3%0.20*0.11 to 0.34
Reason: high bleeding risk
 INR elevated9810.2%767.2%1.43*1.05 to 1.96
 Thrombocytopenia10.1%50.5%0.210.02 to 1.84
 Recent intervention50.5%141.3%0.380.14 to 1.06
 Previous intracranial haemorrhage50.5%121.1%0.450.16 to 1.27
 Intracranial vascular malformation60.6%80.8%0.810.28 to 2.33
 Other30.3%212.0%0.15*0.04 to 0.51
 Full dose heparin or LMWH50.5%151.4%0.36*0.13 to 0.98
 Total12312.8%15114.2%0.860.66 to 1.11
Reason: other
 No good reason according to hospital recommendations323.3%252.4%1.390.82 to 2.36
 Recent stroke252.6%262.5%1.040.59 to 1.81
 Stroke uncertain101.0%484.5%0.22*0.11 to 0.43
 Epileptic seizure50.5%80.8%0.670.22 to 2.06
 Comorbidity/dependency212.2%646.0%0.34*0.20 to 0.56
 Other131.4%131.2%1.080.50 to 2.33
 Total10611.1%18417.4%0.57*0.44 to 0.74
  • 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

  • §χ2 test.

  • ¶Fisher's exact test (expected cell frequency <5).

  • INR, international normalised ratio; LMWH, low molecular weight heparin; NIHSS, National Institute of Health Stroke Scale score; PFO, patent foramen ovale; TOAST, TOAST, Trial of Org 10172 in Acute Stroke Treatment.