Advanced treatment time improves outcomes of patients with ischemic stroke undergoing reperfusion therapy.
- Author:
Hongfang CHEN
1
;
Xiaoxian GONG
2
;
Dongjuan XU
3
;
Zhimin WANG
4
;
Haifang HU
5
;
Chenglong WU
6
;
Xiaoling ZHANG
7
;
Xiaodong MA
8
;
Yaxian WANG
9
;
Haitao HU
2
;
Min LOU
2
;
Zhicai CHEN
2
Author Information
1. Department of Neurology, Jinhua Hospital of Zhejiang University, Jinhua Municipal Central Hospital, Jinhua 321000, Zhejiang Province, China.
2. Department of Neurology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
3. Department of Neurology, Dongyang People's Hospital, Dongyang 322100, Zhejiang Province, China.
4. Department of Neurology, Taizhou First People's Hospital, Taizhou 318020, Zhejiang Province, China.
5. Department of Neurology, the First People's Hospital of Xiaoshan District, Hangzhou 311201, China.
6. Department of Neurology, Shaoxing People's Hospital, Shaoxing 312000, Zhejiang Province, China.
7. Department of Neurology, Jiaxing Second Hospital, Jiaxing 314000, Zhejiang Province, China.
8. Department of Neurology, Haiyan People's Hospital, Haiyan 314300, Zhejiang Province, China.
9. Department of Neurology, Huzhou Central Hospital, Huzhou 313003, Zhejiang Province, China.
- Publication Type:Journal Article
- MeSH:
Brain Ischemia;
drug therapy;
Fibrinolytic Agents;
therapeutic use;
Humans;
Reperfusion;
Retrospective Studies;
Stroke;
drug therapy;
Thrombolytic Therapy;
Time Factors;
Treatment Outcome
- From:
Journal of Zhejiang University. Medical sciences
2019;48(3):247-253
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the effect of treatment time on the outcome of patients with ischemic stroke undergoing reperfusion therapy.
METHODS:The clinical data of 3229 ischemic stroke patients who received intravenous thrombolysis with or without arterial thrombolysis from 71 hospitals in Zhejiang province from June 2017 to September 2018 were retrospectively reviewed. The good outcome was defined as modified Rankin Scale (mRS) ≤ 2. Binary logistic regression analysis was used to investigate the association of door to needle time (DNT), or door to reperfusion time (DRT) with the outcomes in patients treated by intravenous thrombolysis or bridging arterial thrombolysis, respectively.
RESULTS:Binary logistic regression showed that DNT (=0.994, 95%:0.991-0.997, <0.01) or DRT (=0.989, 95%:0.983-0.995, <0.01) were independently associated with good outcomes, respectively. Every hour decreases in DNT resulted in a 4.7%increased probability of functional independence (mRS 0-2) in patients treated by intravenous thrombolysis; Every hour decreases in DRT was associated with a 11.4%increased probability of functional independence in patients treated by intravenous thrombolysis with arterial thrombolysis.
CONCLUSIONS:Good outcomes are associated with lower DNT in ischemic stroke patients treated by intravenous thrombolysis or lower DRT in patients treated by intravenous thrombolysis bridging arterial thrombolysis.
