Factors Affecting the Delay of intravenous Thrombolysis in Hyperacute Ischemic Stroke Patients: A Single Centre Study
Lisda Amalia Department of Neurology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, IndonesiaCorrespondence: Lisda Amalia, Department of Neurology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Jl. Pasteur 38, Bandung, 40...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-05-01
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| Series: | International Journal of General Medicine |
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| Online Access: | https://www.dovepress.com/factors-affecting-the-delay-of-intravenous-thrombolysis-in-hyperacute--peer-reviewed-fulltext-article-IJGM |
| _version_ | 1797814031523774464 |
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| author | Amalia L |
| author_facet | Amalia L |
| author_sort | Amalia L |
| collection | DOAJ |
| description | Lisda Amalia Department of Neurology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, IndonesiaCorrespondence: Lisda Amalia, Department of Neurology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Jl. Pasteur 38, Bandung, 40161, Indonesia, Email dr.lisda@gmail.comIntroduction: Intravenous thrombolysis with r-tPA is the gold standard procedure in managing acute ischemic stroke recommended by the World Stroke Association, which is performed by injecting the drug r-tPA (Alteplase) intravenously. Generally, the preparation time to achieve thrombolysis is divided into pre-hospital and in-hospital. If this time can be shortened, the efficacy of thrombolysis can be increased. This study aims to determine the factors that can affect the delay in thrombolysis.Methods: This is an analytic observational study with a retrospective cohort design in ischemic stroke confirmed by a neurologist at the neurology emergency unit of Hasan Sadikin Hospital (RSHS) from January 2021 to December 2021 and divided into two groups, delay and non-delay thrombolysis. A logistic regression test was performed to determine the independent predictor of delayed thrombolysis.Results: There were 141 patients with an ischemic stroke diagnosis confirmed by a neurologist at the neurological emergency unit at Hasan Sadikin Hospital (RSHS) from January 2021 to December 2021. A total of 118 (83.69%) patients were included in the “delay” category, while 23 (16.31%) patients were included in the “non-delay” category. Patients included in the “delay” category had an average age of 58.29+11.19 years with a male-to-female sex ratio of 57%, while patients included in the “non-delay” category had an average age of 55.57+15.55 years with a male-to-female sex ratio of 66%. The NIHSS admission score was a significant risk factor for delayed thrombolysis. Through multiple logistic regression, it was found that age, onset, female gender, NIHSS admission score, and NIHSS discharge score were independent predictors of delayed thrombolysis. However, all of them were not statistically significant.Conclusion: Gender, risk factors for dyslipidemia, and arrival onset are independent predictors of delayed thrombolysis. Prehospital factors contribute relatively more to the delay in thrombolytic action.Keywords: factor, hyperacute, ischemic, stroke, thrombolysis |
| first_indexed | 2024-03-13T08:01:29Z |
| format | Article |
| id | doaj.art-bc1c2d273cff42d6b629378e18dffbf1 |
| institution | Directory Open Access Journal |
| issn | 1178-7074 |
| language | English |
| last_indexed | 2024-03-13T08:01:29Z |
| publishDate | 2023-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of General Medicine |
| spelling | doaj.art-bc1c2d273cff42d6b629378e18dffbf12023-06-01T16:35:13ZengDove Medical PressInternational Journal of General Medicine1178-70742023-05-01Volume 162157216384122Factors Affecting the Delay of intravenous Thrombolysis in Hyperacute Ischemic Stroke Patients: A Single Centre StudyAmalia LLisda Amalia Department of Neurology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, IndonesiaCorrespondence: Lisda Amalia, Department of Neurology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Jl. Pasteur 38, Bandung, 40161, Indonesia, Email dr.lisda@gmail.comIntroduction: Intravenous thrombolysis with r-tPA is the gold standard procedure in managing acute ischemic stroke recommended by the World Stroke Association, which is performed by injecting the drug r-tPA (Alteplase) intravenously. Generally, the preparation time to achieve thrombolysis is divided into pre-hospital and in-hospital. If this time can be shortened, the efficacy of thrombolysis can be increased. This study aims to determine the factors that can affect the delay in thrombolysis.Methods: This is an analytic observational study with a retrospective cohort design in ischemic stroke confirmed by a neurologist at the neurology emergency unit of Hasan Sadikin Hospital (RSHS) from January 2021 to December 2021 and divided into two groups, delay and non-delay thrombolysis. A logistic regression test was performed to determine the independent predictor of delayed thrombolysis.Results: There were 141 patients with an ischemic stroke diagnosis confirmed by a neurologist at the neurological emergency unit at Hasan Sadikin Hospital (RSHS) from January 2021 to December 2021. A total of 118 (83.69%) patients were included in the “delay” category, while 23 (16.31%) patients were included in the “non-delay” category. Patients included in the “delay” category had an average age of 58.29+11.19 years with a male-to-female sex ratio of 57%, while patients included in the “non-delay” category had an average age of 55.57+15.55 years with a male-to-female sex ratio of 66%. The NIHSS admission score was a significant risk factor for delayed thrombolysis. Through multiple logistic regression, it was found that age, onset, female gender, NIHSS admission score, and NIHSS discharge score were independent predictors of delayed thrombolysis. However, all of them were not statistically significant.Conclusion: Gender, risk factors for dyslipidemia, and arrival onset are independent predictors of delayed thrombolysis. Prehospital factors contribute relatively more to the delay in thrombolytic action.Keywords: factor, hyperacute, ischemic, stroke, thrombolysishttps://www.dovepress.com/factors-affecting-the-delay-of-intravenous-thrombolysis-in-hyperacute--peer-reviewed-fulltext-article-IJGMfactorhyperacuteischemicstrokethrombolysis |
| spellingShingle | Amalia L Factors Affecting the Delay of intravenous Thrombolysis in Hyperacute Ischemic Stroke Patients: A Single Centre Study International Journal of General Medicine factor hyperacute ischemic stroke thrombolysis |
| title | Factors Affecting the Delay of intravenous Thrombolysis in Hyperacute Ischemic Stroke Patients: A Single Centre Study |
| title_full | Factors Affecting the Delay of intravenous Thrombolysis in Hyperacute Ischemic Stroke Patients: A Single Centre Study |
| title_fullStr | Factors Affecting the Delay of intravenous Thrombolysis in Hyperacute Ischemic Stroke Patients: A Single Centre Study |
| title_full_unstemmed | Factors Affecting the Delay of intravenous Thrombolysis in Hyperacute Ischemic Stroke Patients: A Single Centre Study |
| title_short | Factors Affecting the Delay of intravenous Thrombolysis in Hyperacute Ischemic Stroke Patients: A Single Centre Study |
| title_sort | factors affecting the delay of intravenous thrombolysis in hyperacute ischemic stroke patients a single centre study |
| topic | factor hyperacute ischemic stroke thrombolysis |
| url | https://www.dovepress.com/factors-affecting-the-delay-of-intravenous-thrombolysis-in-hyperacute--peer-reviewed-fulltext-article-IJGM |
| work_keys_str_mv | AT amalial factorsaffectingthedelayofintravenousthrombolysisinhyperacuteischemicstrokepatientsasinglecentrestudy |