Barriers to Stroke Thrombolysis
Introduction: Thrombolytic therapy with intravenous recombinant tissue plasminogen activator (rt-PA) is the cornerstone of acute ischaemic stroke treatment. The number of stroke patients receiving thrombolytic therapy in India has improved over the recent years. However, Warangal despite being...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2017-12-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/10919/31815_021217_31815_F(AP)_(PB_BT_SU_AP)_PFA(MJ_GG)_PFA2(MJ_SS).pdf |
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| author | Ajay Panwar Madhavarao Veeramalla Chandrasekhar Valupadas Kurimilla Ramesh Mohammed Owais Rohini Muriki |
| author_facet | Ajay Panwar Madhavarao Veeramalla Chandrasekhar Valupadas Kurimilla Ramesh Mohammed Owais Rohini Muriki |
| author_sort | Ajay Panwar |
| collection | DOAJ |
| description | Introduction: Thrombolytic therapy with intravenous
recombinant tissue plasminogen activator (rt-PA) is the
cornerstone of acute ischaemic stroke treatment. The number
of stroke patients receiving thrombolytic therapy in India has
improved over the recent years. However, Warangal despite
being the second largest city in Telangana, witnesses stroke
thrombolysis infrequently.
Aim: To study the factors which prevent stroke thrombolysis at
a tertiary care center in Warangal.
Materials and Methods: The study was undertaken at Kakatiya
Medical College (KMC) and its associate Mahatma Gandhi
Memorial Hospital (MGMH), from October 2016 to March 2017.
The study subjects were recruited from the patients presenting
to medical emergency or neurology outpatient department
(OPD).We enrolled the consecutive ischaemic stroke patients
who presented within three days of the symptoms onset and
fulfilled the inclusion and exclusion criteria for thrombolysis as
defined by the National Institute of Neurological Disorders and
Stroke (NINDS) rt-PA study group. We included the patients
arriving after time window for thrombolysis, so as to study
the causes associated with pre-hospital delay. Thrombolysis
therapy was given within four and a half hours of the stroke
onset.
Results: Among a total of 223 study subjects, only 13 (5.8%)
arrived within the time window for rt-PA infusion and nine (4%)
received thrombolytic therapy. The pre-hospital delay was the
single most important constraint for providing timely stroke
treatment. ‘Lack of awareness of patients and their relatives
to recognize stroke as a medical emergency’ and ‘lack of
awareness about thrombolysis’ were the most important
factors associated with the pre-hospital delay. Non-affordability
and in-hospital delays were the barriers for successful stroke
treatment among the patients who presented to the medical
emergency on time and could not get thrombolytic therapy.
Conclusion: The results of our study suggest the need for a
comprehensive stroke care program at our health center to
escalate the rate of thrombolytic therapy. Stroke education
and awareness modules should be incorporated in the stroke
program. |
| first_indexed | 2024-12-10T08:41:38Z |
| format | Article |
| id | doaj.art-637b6331d7c4429bbbd31df6cb3deda6 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-10T08:41:38Z |
| publishDate | 2017-12-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-637b6331d7c4429bbbd31df6cb3deda62022-12-22T01:55:51ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2017-12-011112OC01OC0510.7860/JCDR/2017/31815.10919Barriers to Stroke ThrombolysisAjay Panwar0Madhavarao Veeramalla1Chandrasekhar Valupadas2Kurimilla Ramesh3Mohammed Owais4Rohini Muriki5Senior Resident Specialist, Department of Neurology, Kakatiya Medical College and Mahatma Gandhi Memorial Hospital, Warangal, Telangana, India.Assistant Professor, Department of Neurology, Kakatiya Medical College and Mahatma Gandhi Memorial Hospital, Warangal, Telangana, India.Professor, Department of Medicine, Kakatiya Medical College and Mahatma Gandhi Memorial Hospital, Warangal, Telangana, India.Professor, Department of Medicine, Kakatiya Medical College and Mahatma Gandhi Memorial Hospital, Warangal, Telangana, India.Postgraduate Resident, Department of Medicine, Kakatiya Medical College and Mahatma Gandhi Memorial Hospital, Warangal, Telangana, India.Postgraduate Resident, Department of Medicine, Kakatiya Medical College and Mahatma Gandhi Memorial Hospital, Warangal, Telangana, India.Introduction: Thrombolytic therapy with intravenous recombinant tissue plasminogen activator (rt-PA) is the cornerstone of acute ischaemic stroke treatment. The number of stroke patients receiving thrombolytic therapy in India has improved over the recent years. However, Warangal despite being the second largest city in Telangana, witnesses stroke thrombolysis infrequently. Aim: To study the factors which prevent stroke thrombolysis at a tertiary care center in Warangal. Materials and Methods: The study was undertaken at Kakatiya Medical College (KMC) and its associate Mahatma Gandhi Memorial Hospital (MGMH), from October 2016 to March 2017. The study subjects were recruited from the patients presenting to medical emergency or neurology outpatient department (OPD).We enrolled the consecutive ischaemic stroke patients who presented within three days of the symptoms onset and fulfilled the inclusion and exclusion criteria for thrombolysis as defined by the National Institute of Neurological Disorders and Stroke (NINDS) rt-PA study group. We included the patients arriving after time window for thrombolysis, so as to study the causes associated with pre-hospital delay. Thrombolysis therapy was given within four and a half hours of the stroke onset. Results: Among a total of 223 study subjects, only 13 (5.8%) arrived within the time window for rt-PA infusion and nine (4%) received thrombolytic therapy. The pre-hospital delay was the single most important constraint for providing timely stroke treatment. ‘Lack of awareness of patients and their relatives to recognize stroke as a medical emergency’ and ‘lack of awareness about thrombolysis’ were the most important factors associated with the pre-hospital delay. Non-affordability and in-hospital delays were the barriers for successful stroke treatment among the patients who presented to the medical emergency on time and could not get thrombolytic therapy. Conclusion: The results of our study suggest the need for a comprehensive stroke care program at our health center to escalate the rate of thrombolytic therapy. Stroke education and awareness modules should be incorporated in the stroke program.https://jcdr.net/articles/PDF/10919/31815_021217_31815_F(AP)_(PB_BT_SU_AP)_PFA(MJ_GG)_PFA2(MJ_SS).pdfischaemic strokethrombolytic therapytissue plasminogen activator |
| spellingShingle | Ajay Panwar Madhavarao Veeramalla Chandrasekhar Valupadas Kurimilla Ramesh Mohammed Owais Rohini Muriki Barriers to Stroke Thrombolysis Journal of Clinical and Diagnostic Research ischaemic stroke thrombolytic therapy tissue plasminogen activator |
| title | Barriers to Stroke Thrombolysis |
| title_full | Barriers to Stroke Thrombolysis |
| title_fullStr | Barriers to Stroke Thrombolysis |
| title_full_unstemmed | Barriers to Stroke Thrombolysis |
| title_short | Barriers to Stroke Thrombolysis |
| title_sort | barriers to stroke thrombolysis |
| topic | ischaemic stroke thrombolytic therapy tissue plasminogen activator |
| url | https://jcdr.net/articles/PDF/10919/31815_021217_31815_F(AP)_(PB_BT_SU_AP)_PFA(MJ_GG)_PFA2(MJ_SS).pdf |
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