Estimating the number of stroke patients eligible for thrombolytic treatment if delay could be avoided
Estimating the number of stroke patients eligible for thrombolytic treatment if delay could be avoided
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DOI：
10.1159/000098330
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发表时间：
2007-01-01
影响因子：
2.9
通讯作者：
van Oostenbrugge, Robert
中科院分区：
文献类型：
--
作者：
Boode, Bep;Welzen, Vivian;van Oostenbrugge, Robert
背景资料：虽然没有数据显示重组组织型纤溶酶原激活剂治疗的潜在患者数量，但据说所有卒中患者中有20%应该接受这种治疗。实际接受治疗的百分比要低得多，主要是由于发病和入院之间的延误。本研究的目的是估计潜在的患者数量适合溶栓治疗，如果这种延迟可以避免。方法：我们收集资料的发病时间，表现和入院的中风病人。根据来自美国国立神经疾病和卒中研究所研究的溶栓的入选和排除标准，我们回顾性估计了符合溶栓治疗条件的患者数量。结果：共纳入263例连续患者。48例患者（18%）在醒来时出现症状，28例（11%）在常规随访时报告了症状，19例（7%）接受了溶栓治疗。所有这些病例均被排除。如果没有发生延迟，另外44例患者（17%）可能接受了溶栓治疗。可治疗患者的潜在损失分别是由于39例患者和2例患者的患者和医生延迟，以及3例患者的其他原因。结论：如果避免延迟，高达24%的脑卒中患者符合溶栓治疗的条件。由于延误主要是由患者自己造成的，这项研究的结果强调了有必要开展运动，以提高公众对中风症状的认识，以及中风是一种紧急情况的认识。版权所有（c）2007 S. Karger AG，巴塞尔。
Background: Although no data are available on the potential number of patients treatable with recombinant tissue plasminogen activator, it is said that up to 20% of all stroke patients should receive this treatment. The actual percentage treated is much lower, mainly due to delays between onset and admission to hospital. The aim of this study was to estimate the potential number of patients eligible for thrombolytic therapy if such delays could be avoided. Methods: We gathered data on the time of onset, presentation and admission of stroke patients. Based on the inclusion and exclusion criteria for thrombolysis derived from the National Institute of Neurological Disorders and Stroke study, we retrospectively estimated the number of patients that would have been eligible for thrombolytic therapy. Results: A total of 263 consecutive patients were included. Forty-eight patients (18%) had symptoms upon awakening, 28 (11%) reported their symptoms at a routine follow-up visit and 19 (7%) received thrombolytic therapy. All these cases were excluded. If no delay had occurred, an additional 44 patients (17%) could have been offered thrombolytic therapy. This potential loss of treatable patients was due to patient and doctor delay in 39 and 2 patients, respectively, and to other reasons in 3 patients. Conclusion: Up to 24% of stroke patients are eligible for thrombolytic treatment if delay is avoided. As delays are mainly caused by patients themselves, the results of this study underline the need for campaigns to improve the public's awareness of stroke symptoms as well as the awareness that stroke is an emergency situation. Copyright (c) 2007 S. Karger AG, Basel.